Marissa Roll, MED, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

2620 Forum Blvd Ste E
Columbia, MO 65203-5454

Phone

(573) 680-0439

NPI assigned

Nov 8, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

Practice roles

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.

• United Cerebral Palsy Heartland

  • Developmentally Disabled Services Day Training Agency
  • Saint Louis, MO
  • NPI 1770645962
  NPD (past)

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510099200000",
    "number": "1770096075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 W EAST RIDGE RD",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652027179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 FORUM BLVD STE E",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652035454",
            "telephone_number": "573-680-0439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLL",
        "first_name": "MARISSA",
        "credential": "MED, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-08",
        "last_updated": "2017-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christian Andres Rojas Moreno, M.D.
• Alexis Roland, SPEECH LANGUAGE PATH
• Jacquline Roland
• William E Roland, M.D.
• Madeline Keiko Roll, PHARMD
• James A Roller, M.D.
• Macy Breanne Roller, OD
• Madalyn Margaret Roller
• Alexandra Rollins, MS
• Mary Ellen Rollins, BSN

• Behavior Analyst in Columbia, MO
• Providers in Columbia, MO by specialty
• Behavior Analyst in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.