Ellakaye Wisdom, ABA

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

License

017422400 Issued in FL

Practice address

1116 Nikki View Dr
Brandon, FL 33511-4868

Phone

(855) 832-6727

NPI assigned

May 11, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Kaye Wisdom Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Associate of Business Administration

State licenses

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1720514532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4575 SE DIXIE HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349976826",
            "telephone_number": "855-832-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 NIKKI VIEW DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114868",
            "telephone_number": "855-832-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISDOM",
        "first_name": "ELLAKAYE",
        "name_prefix": "Ms.",
        "credential": "ABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": "017422400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017422400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYE",
            "last_name": "WISDOM",
            "prefix": "MS.",
            "credential": "B.A.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Justin Winas Jr., DO
• Brittany Wingo, MS CCC SLP
• Darrell Winkle
• Ruth Ann Winkler, O.D.
• Erica Michele Winters
• Carol Lewis Wise, OTR/L
• Jerry A Wishik, M.D.
• Anne Wissman, MSN, APRN, FNP-BC
• Lisa Wolanzyk, LCSW
• Kyle D Wolf, AA

• Assistant Behavior Analyst in Brandon, FL
• Providers in Brandon, FL by specialty
• Assistant Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.