Active NPI
Autumn Gibson
- Behavior Analyst
- Indianapolis, IN
National Provider Identifier
1649729591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 3711 E Southport Rd
Indianapolis, IN 46227-7874 - Phone
- (317) 796-6668
- NPI assigned
- Oct 3, 2016
- Sex
- Female
- Sole proprietor
- No
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
3711 E Southport Rd
Indianapolis, IN 46227-7874
Mailing address
27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5326
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 |
|---|---|---|---|
| Cheryl Swearingan | Past | Accepting new patients | |
| Centrality Behavior Support Training LLC | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 2
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
- Indianapolis, IN
- NPI 1912329020
-
- Family Nurse Practitioner
- Indianapolis, IN
- NPI 1427550243
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578441600000",
"number": "1649729591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27777 INKSTER RD STE 100",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483345326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3711 E SOUTHPORT RD",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462277874",
"telephone_number": "317-796-6668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "AUTUMN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-03",
"last_updated": "2020-01-08",
"certification_date": "2020-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.