Active NPI
Robert Willis, BCBA
- Behavior Analyst
- Lincoln, NE
National Provider Identifier
1629445259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 6311 N 15TH St
Lincoln, NE 68521-8976 - Phone
- (925) 980-9214
- NPI assigned
- Aug 31, 2015
- 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 | Primary |
Addresses
Primary practice location
6311 N 15TH St
Lincoln, NE 68521-8976
Mailing address
6311 N 15TH St
Lincoln, NE 68521-8976
Phone (925) 980-9214
Other practice location 1
7200 S 84th St
LA Vista, NE 68128-2155
Phone (907) 726-5330
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1629445259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6311 N 15TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685218976",
"telephone_number": "925-980-9214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6311 N 15TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685218976",
"telephone_number": "925-980-9214"
}
],
"practiceLocations": [
{
"address_1": "7200 S 84th St",
"address_purpose": "LOCATION",
"city": "LA Vista",
"state": "NE",
"postal_code": "681282155",
"country_code": "US",
"telephone_number": "907-726-5330",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLIS",
"first_name": "ROBERT",
"credential": "BCBA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-08-31",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.