Active NPI
Damani Ako Bailey
- Behavior Technician
- Lawrenceville, GA
National Provider Identifier
1629647599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 2387 Huntcrest Way
Lawrenceville, GA 30043-8126 - Phone
- (678) 648-7644
- NPI assigned
- Jun 23, 2021
- 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
2387 Huntcrest Way
Lawrenceville, GA 30043-8126
Mailing address
2600 Milscott Dr Apt 2532
Decatur, GA 30033-6046
Phone (770) 827-1057
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 |
|---|---|---|---|
| Dogwood Autism Services, LLC | 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": "1624406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683676800000",
"number": "1629647599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 MILSCOTT DR APT 2532",
"city": "DECATUR",
"state": "GA",
"postal_code": "300336046",
"telephone_number": "770-827-1057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2387 HUNTCREST WAY",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300438126",
"telephone_number": "678-648-7644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILEY",
"first_name": "DAMANI",
"middle_name": "AKO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-06-23",
"last_updated": "2023-05-10",
"certification_date": "2023-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.