Andrew P Gwennap

Key facts

NPI

1639974769

Entity type

Individual (NPI type 1)

Primary specialty

Assistant Behavior Analyst 106E00000X

Practice address

107 N Hamilton St
Pratt, KS 67124-1724

Phone

(785) 282-5349

NPI assigned

Feb 13, 2025

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 18, 2025.

{
    "created_epoch": "1739404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1639974769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N HAMILTON ST",
            "city": "PRATT",
            "state": "KS",
            "postal_code": "671241724",
            "telephone_number": "785-282-5349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N HAMILTON ST",
            "city": "PRATT",
            "state": "KS",
            "postal_code": "671241724",
            "telephone_number": "785-282-5349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWENNAP",
        "first_name": "ANDREW",
        "middle_name": "P",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-13",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Pratt, KS · Assistant Behavior Analyst in Kansas