Andrea Ditmore, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

2427 Russellville Rd
Bowling Green, KY 42101-3980

Phone

(270) 936-7472

NPI assigned

Jan 23, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1730719378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BLVD STE 3070",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2427 RUSSELLVILLE RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421013980",
            "telephone_number": "270-936-7472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITMORE",
        "first_name": "ANDREA",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Behavior Technician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.