Sherry Denise Connell, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-07-3348 Issued in TN

Practice address

145 Bethel Court
Bethel Autism Institute
McKenzie, TN 38201

Phone

(731) 514-6601

Fax

(731) 881-7933

NPI assigned

Feb 7, 2017

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1669910907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 105",
            "city": "GLEASON",
            "state": "TN",
            "postal_code": "382290105",
            "telephone_number": "731-514-6601",
            "fax_number": "731-881-7933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 BETHEL COURT",
            "address_2": "BETHEL AUTISM INSTITUTE",
            "city": "MCKENZIE",
            "state": "TN",
            "postal_code": "38201",
            "telephone_number": "731-514-6601",
            "fax_number": "731-881-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "SHERRY",
        "middle_name": "DENISE",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-07",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TN",
            "license": "1-07-3348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ambulance Services of McKenzie, Inc.
• Madison Beaird, COTA
• Trent Wade Borders, MD
• Cassie Denise Butler, PTA
• Robert Allan Eldredge, ATC
• Jennifer Rene Jennings, FNP-BC
• McKenzie Medical Center PC
• Darolyn Leah Nyhan, LAT, ATC
• Ginger Lynn Oliver, SLP

• All providers in McKenzie, TN
• Behavior Analyst in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; 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.