Individual provider Active NPI

Chelsea Brooke Tolliver, RBT

  • Behavior Analyst
  • Knoxville, TN
National Provider Identifier
1528618691
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-21-52450 Issued in TN
Practice address
9038 Cross Park Dr Ste 105
Knoxville, TN 37923-4720
Phone
(865) 394-6612
Fax
(865) 315-7014
NPI assigned
Sep 19, 2019
Last updated
Sep 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-21-52450 TN Primary
Behavior Technician 106S00000X RBT-19-95618 TN

Addresses

Primary practice location

9038 Cross Park Dr Ste 105
Knoxville, TN 37923-4720

Mailing address

9038 Cross Park Dr Ste 105
Knoxville, TN 37923-4720
Phone (865) 394-6612

Other identifiers 1

IdentifierTypeStateIssuer
1-21-52450OtherTNBACB

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RBT-19-95618TNMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
ABA Interventions, LLC Behavior Analyst PastSince Sep 25, 2019 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1528618691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9038 CROSS PARK DR STE 105",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234720",
            "telephone_number": "865-394-6612",
            "fax_number": "865-315-7014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9038 CROSS PARK DR STE 105",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234720",
            "telephone_number": "865-394-6612",
            "fax_number": "865-315-7014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLIVER",
        "first_name": "CHELSEA",
        "middle_name": "BROOKE",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-19",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TN",
            "license": "1-21-52450",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TN",
            "license": "RBT-19-95618",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BACB",
            "identifier": "1-21-52450",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; 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.