Active NPI
Kylie Bumgarner
- Behavior Technician
- Middletown, DE
National Provider Identifier
1548968472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 106S0000X
- Practice address
- 108 Patriot Dr Ste a
Middletown, DE 19709-8803 - Phone
- (302) 632-1717
- NPI assigned
- Feb 20, 2023
- Last updated
- Feb 20, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 106S0000X | DE | Primary |
Addresses
Primary practice location
108 Patriot Dr Ste a
Middletown, DE 19709-8803
Mailing address
46 Central Park Dr
Harrington, DE 19952-2257
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
| License | State | Type | Specialty |
|---|---|---|---|
| 106S0000X | DE | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676851200000",
"number": "1548968472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46 CENTRAL PARK DR",
"city": "HARRINGTON",
"state": "DE",
"postal_code": "199522257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 PATRIOT DR STE A",
"city": "MIDDLETOWN",
"state": "DE",
"postal_code": "197098803",
"telephone_number": "302-632-1717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUMGARNER",
"first_name": "KYLIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-20",
"last_updated": "2023-02-20",
"certification_date": "2023-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "DE",
"license": "106S0000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.