Individual provider Active NPI

Andrea Dawn Newkirk, MA, BCBA, LBA

  • Behavior Analyst
  • Phoenix, AZ
National Provider Identifier
1649723685
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BEH-001640 Issued in AZ
Practice address
2001 N 3Rd St Ste 100
Phoenix, AZ 85004-1495
Phone
(602) 922-6760
Fax
(317) 520-8200
NPI assigned
Jul 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Behavior Analyst 103K00000X 1-16-22901 GA
Behavior Analyst 103K00000X BEH-001640 AZ Primary

Addresses

Primary practice location

2001 N 3Rd St Ste 100
Phoenix, AZ 85004-1495

Mailing address

3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885

Other practice location 1

2083 Newnan Crossing Blvd E
Newnan, GA 30265-2606
Phone (470) 241-1408

Other practice location 2

5220 N Dysart Rd Bldg C
Litchfield Park, AZ 85340-3045
Phone (623) 244-9179

Other identifiers 1

IdentifierTypeStateIssuer
1-16-22901OtherBCBA CERTIFICATE

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
BEH-001640AZMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Autism Spectrum Therapies, LLC Behavior Analyst Past Accepting new patients
Hopebridge, LLC Behavior Analyst Past Accepting new patients
Behavior Analysis Center for Autism Behavior Analyst Past Accepting new patients
Hopebridge, LLC Behavior Analyst Past Accepting new patients

Organizations & group practices 4

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": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1649723685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BLVD STE 3070",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686135",
            "telephone_number": "855-324-0885",
            "fax_number": "317-520-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 N 3RD ST STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041495",
            "telephone_number": "602-922-6760",
            "fax_number": "317-520-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2083 Newnan Crossing Blvd E",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302652606",
            "country_code": "US",
            "telephone_number": "470-241-1408",
            "fax_number": "317-520-8200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5220 N Dysart Rd Bldg C",
            "address_purpose": "LOCATION",
            "city": "Litchfield Park",
            "state": "AZ",
            "postal_code": "853403045",
            "country_code": "US",
            "telephone_number": "623-244-9179",
            "fax_number": "317-520-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEWKIRK",
        "first_name": "ANDREA",
        "middle_name": "DAWN",
        "credential": "MA, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-26",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "1-16-22901",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AZ",
            "license": "BEH-001640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA CERTIFICATE",
            "identifier": "1-16-22901",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.