Active NPI
Kristy E Walker
- Behavior Analyst
- Marion, IA
National Provider Identifier
1760235691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 123057
- Practice address
- 3297 Armar Dr
Marion, IA 52302-4748 - Phone
- (563) 526-0533
- Fax
- (574) 204-2868
- NPI assigned
- Apr 10, 2024
- Last updated
- Apr 10, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 123057 | IA | Primary |
Addresses
Primary practice location
3297 Armar Dr
Marion, IA 52302-4748
Mailing address
215 Red Coach Dr
Mishawaka, IN 46545-8307
Phone (765) 628-7400
Other names 1
- Kristy E Depalma
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 |
|---|---|---|---|
| 123057 | IA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vav Operations Ia LLC | Behavior Analyst | Past | Accepting new patients |
| Vav Operations LLC | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Lighthouse Autism Center
- Community/Behavioral Health Agency
- Davenport, IA
- NPI 1194439661
Behavior Analyst
-
dba Lighthouse Autism Center
- Community/Behavioral Health Agency
- South Bend, IN
- NPI 1942576905
Behavior Analyst
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712707200000",
"number": "1760235691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 RED COACH DR",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465458307",
"telephone_number": "765-628-7400",
"fax_number": "574-204-2868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3297 ARMAR DR",
"city": "MARION",
"state": "IA",
"postal_code": "523024748",
"telephone_number": "563-526-0533",
"fax_number": "574-204-2868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "KRISTY",
"middle_name": "E",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-10",
"last_updated": "2024-04-10",
"certification_date": "2024-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IA",
"license": "123057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KRISTY",
"last_name": "DEPALMA",
"middle_name": "E",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Marion, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.