Individual provider Active NPI

Charity Bankston, BCBA

  • Behavior Analyst
  • Clarksville, TN
National Provider Identifier
1578074118
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
203 Harnett CT
Clarksville, TN 37043-1966
Phone
(615) 376-0034
NPI assigned
Oct 23, 2017
Last updated
Sep 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

203 Harnett CT
Clarksville, TN 37043-1966

Mailing address

203 Harnett CT
Clarksville, TN 37043-1966

Other practice location 1

941 Professional Park Dr
Clarksville, TN 37040-5137
Phone (615) 376-0034

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

OrganizationSpecialtyStatusNew patients
Bloom Therapy Center, LLC Current Accepting new patients
Autism Education & Therapy Center, LLC PastSince Oct 2, 2022 Accepting new patients

Locations

120 Dunbar Cave Rd
Ste A
Clarksville, TN 37043

Organizations & group practices 2

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": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1578074118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 HARNETT CT",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370431966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 HARNETT CT",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370431966",
            "telephone_number": "615-376-0034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "941 Professional Park Dr",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370405137",
            "country_code": "US",
            "telephone_number": "615-376-0034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANKSTON",
        "first_name": "CHARITY",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-23",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.