Active NPI
Riley Grussing
- Behavior Analyst
- Maple Grove, MN
National Provider Identifier
1700436169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 4859
- Practice address
- 8980 Zachary LN N
Maple Grove, MN 55369-4018 - Phone
- (612) 331-9413
- NPI assigned
- Sep 18, 2019
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 4859 | TX | Primary |
| Behavior Technician | 106S00000X |
Addresses
Primary practice location
8980 Zachary LN N
Maple Grove, MN 55369-4018
Mailing address
13581 Pond Springs Rd
Austin, TX 78729-4421
Phone (512) 688-8530
Other practice location 1
205 14th Ave E
Sartell, MN 56377-4500
Phone (320) 774-3436
Other practice location 2
108 Doctors Park
Saint Cloud, MN 56303-1207
Phone (320) 774-3915
Other practice location 3
13581 Pond Springs Rd
Austin, TX 78729-4421
Phone (512) 688-8530
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 |
|---|---|---|---|
| 4859 | TX | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northway Academy, Inc. | Past | Accepting new patients | |
| Hidden Talents ABA | Behavior Analyst | Past | Accepting new patients |
| Northway Academy, Inc. | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Developmental Disabilities Clinic/Center
- Saint Cloud, MN
- NPI 1104333715
-
- Community/Behavioral Health Agency
- Sartell, MN
- NPI 1841852639
-
- Behavior Analyst
- Atlanta, GA
- NPI 1003436684
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646006400000",
"number": "1700436169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13581 POND SPRINGS RD",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787294421",
"telephone_number": "512-688-8530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8980 ZACHARY LN N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553694018",
"telephone_number": "612-331-9413"
}
],
"practiceLocations": [
{
"address_1": "205 14th Ave E",
"address_purpose": "LOCATION",
"city": "Sartell",
"state": "MN",
"postal_code": "563774500",
"country_code": "US",
"telephone_number": "320-774-3436",
"fax_number": "320-774-3440",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "108 Doctors Park",
"address_purpose": "LOCATION",
"city": "Saint Cloud",
"state": "MN",
"postal_code": "563031207",
"country_code": "US",
"telephone_number": "320-774-3915",
"fax_number": "320-774-3918",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "13581 Pond Springs Rd",
"address_purpose": "LOCATION",
"city": "Austin",
"state": "TX",
"postal_code": "787294421",
"country_code": "US",
"telephone_number": "512-688-8530",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRUSSING",
"first_name": "RILEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-18",
"last_updated": "2022-02-28",
"certification_date": "2022-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "4859",
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Maple Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.