Active NPI
Bradley Ivan Gilmore, RBT
- Behavior Technician
- Bothell, WA
National Provider Identifier
1558829697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 20014 Jewell Rd
Bothell, WA 98012-7317 - Phone
- (425) 949-0801
- NPI assigned
- Mar 7, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
20014 Jewell Rd
Bothell, WA 98012-7317
Mailing address
20014 Jewell Rd
Bothell, WA 98012-7317
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Behavior Place | Single Specialty | Past | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551916800000",
"number": "1558829697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20014 JEWELL RD",
"city": "BOTHELL",
"state": "WA",
"postal_code": "980127317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20014 JEWELL RD",
"city": "BOTHELL",
"state": "WA",
"postal_code": "980127317",
"telephone_number": "425-949-0801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILMORE",
"first_name": "BRADLEY",
"middle_name": "IVAN",
"credential": "RBT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-07",
"last_updated": "2019-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bothell, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.