Jamie Nichole Kelly, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-21-51223 Issued in IN

Practice address

315 Washington St
Columbus, IN 47201-6743

Phone

(812) 413-9321

Fax

(812) 413-9323

NPI assigned

Jul 7, 2021

Last updated

Jul 7, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Imprint Pediatric Therapy LLC.

  • Behavior Analyst
  • Nashville, IN
  • NPI 1902371396
  NPD (past)

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1669043048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 S NORRIS AVE",
            "city": "NORTH VERNON",
            "state": "IN",
            "postal_code": "472657118",
            "telephone_number": "812-413-9321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 WASHINGTON ST",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472016743",
            "telephone_number": "812-413-9321",
            "fax_number": "812-413-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JAMIE",
        "middle_name": "NICHOLE",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1-21-51223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca J Keach, OT
• Emily Keith, RBT
• Susan Kell, CNS
• Michael E. Keller, D.D.S., M.S.D.
• Franchesca Kelly, RBT
• Katherine Monica Kelly, RN/NP
• Rory Kelly
• Dasha Kenlan, M.D.
• Kenneth Kennedy
• Kenney Orthopedics of Columbus, LLC (Hanger Clinic)

• Behavior Analyst in Columbus, IN
• Providers in Columbus, IN by specialty
• Behavior Analyst in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; 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.