Active NPI
Kayla Elizabeth Bates-Brantley
- Clinical Child & Adolescent Psychologist
- Mississippi State, MS
National Provider Identifier
1700266947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 631161
- Practice address
- 1219 Blackjack Road
Mississippi State, MS 39762-9727 - Phone
- (662) 325-0152
- NPI assigned
- Jun 3, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 631161 | MS | Primary |
| Behavior Analyst | 103K00000X |
Addresses
Primary practice location
1219 Blackjack Road
Mississippi State, MS 39762-9727
Mailing address
PO Box 9727
Mississippi State, MS 39762-9727
Phone (623) 253-4266
Other practice location 1
444 S 44th St
Omaha, NE 68131
Phone (402) 559-6408
Other practice location 2
32 Millbranch Rd Ste 40
Hattiesburg, MS 39402
Phone (601) 255-5264
Other names 1
- Kayla Elizabeth Bates
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 |
|---|---|---|---|
| 631161 | MS | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700006400000",
"number": "1700266947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9727",
"city": "MISSISSIPPI STATE",
"state": "MS",
"postal_code": "397629727",
"telephone_number": "623-253-4266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1219 BLACKJACK ROAD",
"city": "MISSISSIPPI STATE",
"state": "MS",
"postal_code": "397629727",
"telephone_number": "662-325-0152"
}
],
"practiceLocations": [
{
"address_1": "444 S 44th St",
"address_purpose": "LOCATION",
"city": "Omaha",
"state": "NE",
"postal_code": "68131",
"country_code": "US",
"telephone_number": "402-559-6408",
"fax_number": "402-559-5737",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "32 Millbranch Rd Ste 40",
"address_purpose": "LOCATION",
"city": "Hattiesburg",
"state": "MS",
"postal_code": "39402",
"country_code": "US",
"telephone_number": "601-255-5264",
"fax_number": "866-625-0559",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BATES-BRANTLEY",
"first_name": "KAYLA",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-03",
"last_updated": "2023-11-15",
"certification_date": "2023-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "MS",
"license": "631161",
"primary": true
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KAYLA",
"last_name": "BATES",
"middle_name": "ELIZABETH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Mississippi State, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.