Active NPI
John Kennedy, BCBA, LABA
- Behavior Analyst
- Birmingham, AL
National Provider Identifier
1588094601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 2024-001
- Practice address
- 2000 2ND Ave S Apt 353
Birmingham, AL 35233-2077 - Phone
- (508) 971-2140
- NPI assigned
- Nov 27, 2013
- 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 Analyst | 103K00000X | 2024-001 | AL | Primary |
Addresses
Primary practice location
2000 2ND Ave S Apt 353
Birmingham, AL 35233-2077
Mailing address
7108 S Kanner Hwy
Stuart, FL 34997-7462
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110026265 | Medicaid | MA |
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 |
|---|---|---|---|
| 2024-001 | AL | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1385510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705881600000",
"number": "1588094601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7108 S KANNER HWY",
"city": "STUART",
"state": "FL",
"postal_code": "349977462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 2ND AVE S APT 353",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352332077",
"telephone_number": "508-971-2140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "JOHN",
"credential": "BCBA, LABA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-27",
"last_updated": "2024-01-22",
"certification_date": "2024-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "AL",
"license": "2024-001",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110026265",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.