Individual provider Active NPI

Bryan E Setterlund, BCBA

  • Behavior Analyst
  • Fort Worth, TX
National Provider Identifier
1649943473
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-24-73841 Issued in TX
Practice address
4541 Heritage Trace Pkwy
Fort Worth, TX 76244-8948
Phone
(817) 385-7140
NPI assigned
Jul 28, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-24-73841 TX Primary

Addresses

Primary practice location

4541 Heritage Trace Pkwy
Fort Worth, TX 76244-8948

Mailing address

1901 S Main St
Keller, TX 76248-5120
Phone (817) 691-3283

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1649943473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 S MAIN ST",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762485120",
            "telephone_number": "817-691-3283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4541 HERITAGE TRACE PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448948",
            "telephone_number": "817-385-7140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SETTERLUND",
        "first_name": "BRYAN",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-24-73841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.