Individual provider Active NPI

Teresa Michele Thompson

  • Behavior Technician
  • Fayetteville, AR
National Provider Identifier
1699452706
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
161862 Issued in CA
Practice address
2203 E Cinnamon Way
Fayetteville, AR 72703-4540
Phone
(479) 244-5014
NPI assigned
Jun 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 161862 CA Primary

Addresses

Primary practice location

2203 E Cinnamon Way
Fayetteville, AR 72703-4540

Mailing address

2203 E Cinnamon Way
Fayetteville, AR 72703-4540
Phone (479) 455-5014

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

LicenseStateTypeSpecialty
161862CAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1699452706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 E CINNAMON WAY",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034540",
            "telephone_number": "479-455-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 E CINNAMON WAY",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034540",
            "telephone_number": "479-244-5014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "TERESA",
        "middle_name": "MICHELE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-30",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "161862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.

Verify at the official NPI Registry.