Kaitlyn C Poythress, MA, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

2023046696 Issued in MO

Practice address

614 E Adams St
Jackson, MO 63755-2150

Phone

(573) 243-9501

NPI assigned

Apr 24, 2024

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

Credentials

Master of Arts

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.

• Jackson R-2 Schools

  • Local Education Agency (LEA)
  • Jackson, MO
  • NPI 1053564245
  NPD (past)

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

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1548016397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 JENNIFER DR",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637558708",
            "telephone_number": "573-450-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 E ADAMS ST",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637552150",
            "telephone_number": "573-243-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POYTHRESS",
        "first_name": "KAITLYN",
        "middle_name": "C",
        "credential": "MA, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-23-67680",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "2023046696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aliecia Diann Penrod
• Charles S Pewitt, DO
• Julia Annette Pewitt, D.O.
• Richel Pingkian
• Lindsey Michelle Pippins, MABC, BT, QIDP, DDP
• Alissa Marie Quaite, ED.S, LPC, RPT
• Quincy Medical Supplies, LLC
• Chelsea R Reese, L.M.T.
• Kathryn Reitman, CLC, CLE, CLD
• Nicole Reyes

• Behavior Analyst in Jackson, MO
• Providers in Jackson, MO by specialty
• Behavior Analyst in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.