Active NPI
Elizabeth Daughtry
- Behavior Analyst
- Atmore, AL
National Provider Identifier
1699376822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 2023-144
- Practice address
- 429 Buford L Rolin Dr
Atmore, AL 36502-5190 - Phone
- (251) 368-9136
- NPI assigned
- Nov 4, 2020
- Last updated
- Nov 29, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 2023-144 | AL | Primary |
Addresses
Primary practice location
429 Buford L Rolin Dr
Atmore, AL 36502-5190
Mailing address
5811 Jack Springs Rd
Atmore, AL 36502-5025
Other practice location 1
517 Martin Rd
Atmore, AL 36502-5239
Phone (251) 368-9136
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2023-144 | AL | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Poarch Band of Creek Indians | Multi-Specialty | Past | Accepting new patients |
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/148f5931-d9cf-4d65-8c66-7021ed161b73/
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.
-
dba Poarch Creek Indian Health Department
- Federally Qualified Health Center (FQHC)
- Atmore, AL
- NPI 1902916489
Multi-Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701216000000",
"number": "1699376822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5811 JACK SPRINGS RD",
"city": "ATMORE",
"state": "AL",
"postal_code": "365025025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "429 BUFORD L ROLIN DR",
"city": "ATMORE",
"state": "AL",
"postal_code": "365025190",
"telephone_number": "251-368-9136"
}
],
"practiceLocations": [
{
"address_1": "517 Martin Rd",
"address_purpose": "LOCATION",
"city": "Atmore",
"state": "AL",
"postal_code": "365025239",
"country_code": "US",
"telephone_number": "251-368-9136",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAUGHTRY",
"first_name": "ELIZABETH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-04",
"last_updated": "2023-11-29",
"certification_date": "2023-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "AL",
"license": "2023-144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atmore, AL
- Selina Chee, PHARM.D.
- Keith Scott Classen, FNP
- John Taylor Cooper, O.D.
- Felecia Crawford, FNP
- Latisha Sharnice Dailey
- Denton Dental of Atmore PC Dba Save-on Dental Care of Atmore
- Paul J Dirkes, DDS
- Dr Latisha Dailey LLC
- Dura-Med Southeast, Inc (Greenlawn Home Medical)
- Priscilla Beverly Durand-Mitchelle, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.