Active NPI
Kelly Rose, BCBA, LBA
- Behavior Analyst
- Virginia Beach, VA
National Provider Identifier
1740728096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 0133000916
- Practice address
- 325 Teal Cres
Virginia Beach, VA 23456-4518 - Phone
- (757) 426-2431
- NPI assigned
- Feb 7, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 0133000916 | VA | Primary |
Addresses
Primary practice location
325 Teal Cres
Virginia Beach, VA 23456-4518
Mailing address
325 Teal Cres
Virginia Beach, VA 23456-4518
Phone (757) 426-2431
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 |
|---|---|---|---|
| 0133000916 | VA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486425600000",
"number": "1740728096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 TEAL CRES",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234564518",
"telephone_number": "757-426-2431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 TEAL CRES",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234564518",
"telephone_number": "757-426-2431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "KELLY",
"name_prefix": "Mrs.",
"credential": "BCBA, LBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-07",
"last_updated": "2017-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "VA",
"license": "0133000916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.