Active NPI
Bethany Ricks
- Behavior Analyst
- Rexburg, ID
National Provider Identifier
1649806605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1252 Crescent Dr
Rexburg, ID 83440-5261 - Phone
- (208) 390-0888
- NPI assigned
- Mar 20, 2020
- Last updated
- Mar 29, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary | ||
| Behavior Technician | 106S00000X |
Addresses
Primary practice location
1252 Crescent Dr
Rexburg, ID 83440-5261
Mailing address
1252 Crescent Dr
Rexburg, ID 83440-5261
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 |
|---|---|---|---|
| Autism Living Experience, LLC | Behavior Analyst | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711670400000",
"number": "1649806605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1252 CRESCENT DR",
"city": "REXBURG",
"state": "ID",
"postal_code": "834405261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1252 CRESCENT DR",
"city": "REXBURG",
"state": "ID",
"postal_code": "834405261",
"telephone_number": "208-390-0888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICKS",
"first_name": "BETHANY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-20",
"last_updated": "2024-03-29",
"certification_date": "2024-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rexburg, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.