Active NPI
Theresa B Johnson
- Behavior Analyst
- Bailey, CO
National Provider Identifier
1649609082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 116 Bluebird Dr
Bailey, CO 80421-2004 - Phone
- (404) 643-3621
- NPI assigned
- Nov 6, 2013
- 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 Analyst | 103K00000X | Primary |
Addresses
Primary practice location
116 Bluebird Dr
Bailey, CO 80421-2004
Mailing address
116 Bluebird Dr
Bailey, CO 80421-2004
Phone (404) 643-3621
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9000141643 | Medicaid | CO |
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 |
|---|---|---|---|
| Integrated Theraplay | Behavior Analyst | Current | 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
- Bailey, CO
- NPI 1295320596
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759622400000",
"number": "1649609082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 BLUEBIRD DR",
"city": "BAILEY",
"state": "CO",
"postal_code": "804212004",
"telephone_number": "404-643-3621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 BLUEBIRD DR",
"city": "BAILEY",
"state": "CO",
"postal_code": "804212004",
"telephone_number": "404-643-3621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "THERESA",
"middle_name": "B",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-06",
"last_updated": "2025-10-05",
"certification_date": "2025-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9000141643",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bailey, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.