Active NPI
Melanna Underwood
- Behavior Technician
- Bloomington, IN
National Provider Identifier
1770338378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-237427
- Practice address
- 2010 S Yost Ave
Bloomington, IN 47403-3188 - Phone
- (812) 822-0605
- NPI assigned
- Apr 18, 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 Technician | 106S00000X | RBT-22-237427 | IN | Primary |
Addresses
Primary practice location
2010 S Yost Ave
Bloomington, IN 47403-3188
Mailing address
5677 Nebo Country Dr
Martinsville, IN 46151-6056
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 |
|---|---|---|---|
| RBT-22-237427 | IN | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids Play Sensory Gym LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinic/Center
- Bloomington, IN
- NPI 1922518463
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713398400000",
"number": "1770338378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5677 NEBO COUNTRY DR",
"city": "MARTINSVILLE",
"state": "IN",
"postal_code": "461516056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2010 S YOST AVE",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474033188",
"telephone_number": "812-822-0605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UNDERWOOD",
"first_name": "MELANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-18",
"last_updated": "2024-04-18",
"certification_date": "2024-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IN",
"license": "RBT-22-237427",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.