Kelli Ammon, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

11109001-2506 Issued in UT

Practice address

6196 Lake Gray Blvd Ste 117
Jacksonville, FL 32244-5867

Phone

(855) 300-6408

Fax

(904) 578-5103

NPI assigned

Jun 9, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brightstone Therapy LLC

  • Behavior Analyst
  • Orange Park, FL
  • NPI 1396432860
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1528417680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10175 FORTUNE PKWY UNIT 903",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566755",
            "telephone_number": "904-538-0713",
            "fax_number": "904-538-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6196 LAKE GRAY BLVD STE 117",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322445867",
            "telephone_number": "855-300-6408",
            "fax_number": "904-578-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMMON",
        "first_name": "KELLI",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "UT",
            "license": "11109001-2506",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amit Chokshi MD PA
• Amit Vijapura MD PA
• Venkata Raghava Ammanabrolu
• Yazan Ammari, PHARM.D
• Ammd Ventures Inc
• Ayanna Ammons
• Christelle Ammons, PA-C
• Alexandria Amodeo, M.A.
• Elizabeth Amoff, DDS
• Amole Care LLC

• Behavior Analyst in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.