Individual provider Active NPI

Kerrianne Courtney Webster, MS, BCBA, LBA

  • Behavior Analyst
  • Mobile, AL
National Provider Identifier
1790046480
Registry record updated Mar 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
2017-018 Issued in AL
Practice address
5465 Able CT
Mobile, AL 36693-3100
Phone
(251) 644-5938
Fax
(334) 283-2350
NPI assigned
May 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 2017-018 AL Primary

Addresses

Primary practice location

5465 Able CT
Mobile, AL 36693-3100

Mailing address

5451 Able CT
Mobile, AL 36693-3100
Phone (251) 410-0160

Other identifiers 3

IdentifierTypeStateIssuer
1-14-15066OtherBEHAVIOR ANALYST CERTIFICATION BOARD
14074198OtherCAQH
2017-018OtherALALABAMA BEHAVIOR ANALYST LICENSURE BOARD

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2017-018ALMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1790046480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5451 ABLE CT",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366933100",
            "telephone_number": "251-410-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5465 ABLE CT",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366933100",
            "telephone_number": "251-644-5938",
            "fax_number": "334-283-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBSTER",
        "first_name": "KERRIANNE",
        "middle_name": "COURTNEY",
        "name_prefix": "Mrs.",
        "credential": "MS, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AL",
            "license": "2017-018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR ANALYST CERTIFICATION BOARD",
            "identifier": "1-14-15066",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14074198",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA BEHAVIOR ANALYST LICENSURE BOARD",
            "identifier": "2017-018",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

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