Active NPI
Kaylie Grimes
- Behavior Technician
- Rockwall, TX
National Provider Identifier
1639765209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-20-110187
- Practice address
- 2701 Sunset Ridge Dr
Rockwall, TX 75032-0005 - Phone
- (469) 458-9021
- NPI assigned
- Dec 17, 2020
- Sex
- Female
- 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 | RBT-20-110187 | TX | Primary |
Addresses
Primary practice location
2701 Sunset Ridge Dr
Rockwall, TX 75032-0005
Mailing address
911 N Goliad St
Rockwall, TX 75087-2230
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 |
|---|---|---|---|
| RBT-20-110187 | TX | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Transformations, LLC | 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.
-
- Behavior Analyst
- Garland, TX
- NPI 1316336043
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608163200000",
"number": "1639765209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "911 N GOLIAD ST",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "750872230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 SUNSET RIDGE DR",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "750320005",
"telephone_number": "469-458-9021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMES",
"first_name": "KAYLIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-17",
"last_updated": "2020-12-17",
"certification_date": "2020-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TX",
"license": "RBT-20-110187",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockwall, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.