Individual provider Active NPI

Madelyn Stott

  • Behavior Analyst
  • Centennial, CO
National Provider Identifier
1639796782
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-21-56470 Issued in CO
Practice address
12503 E Euclid Dr Ste 55
Centennial, CO 80111-6466
Phone
(888) 754-0398
NPI assigned
Jul 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-19-80184 CO
Behavior Analyst 103K00000X 1-21-56470 CO Primary

Addresses

Primary practice location

12503 E Euclid Dr Ste 55
Centennial, CO 80111-6466

Mailing address

6416 NW 5TH Way
Ft Lauderdale, FL 33309-6112
Phone (888) 754-0398

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL 1811352099 Direct Vocational Development Group, LLC

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

LicenseStateTypeSpecialty
RBT-19-80184COMDBehavior Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1593907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1639796782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6416 NW 5TH WAY",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333096112",
            "telephone_number": "888-754-0398",
            "fax_number": "954-982-6491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12503 E EUCLID DR STE 55",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801116466",
            "telephone_number": "888-754-0398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOTT",
        "first_name": "MADELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-05",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CO",
            "license": "RBT-19-80184",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CO",
            "license": "1-21-56470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "1811352099",
            "affiliation": "Y",
            "affiliationName": "Vocational Development Group, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12503 E Euclid Dr Ste 55",
            "city": "Centennial",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801116466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.