Active NPI
Alyssa Rouse
- Behavior Analyst
- Decatur, GA
National Provider Identifier
1790048197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 465 Winn Way Ste 140
Decatur, GA 30030-1722 - Phone
- (470) 403-2830
- Fax
- (470) 427-5560
- NPI assigned
- Jun 20, 2012
- Last updated
- May 19, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | |||
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
465 Winn Way Ste 140
Decatur, GA 30030-1722
Mailing address
300 International Pkwy Ste 200
Lake Mary, FL 32746-5028
Phone (866) 610-0580
Other practice location 1
225 Cedar Hill St Ste 200
Marlborough, MA 01752-5900
Phone (857) 829-4040
Other practice location 2
20 Marietta St NW Apt 5B
Atlanta, GA 30303-2822
Phone (516) 983-3161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| YLD84037016 | Other | NY | EMPIRE BLUECROSS BLUESHIELD |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621382400000",
"number": "1790048197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 INTERNATIONAL PKWY STE 200",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327465028",
"telephone_number": "866-610-0580",
"fax_number": "407-588-6294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "465 WINN WAY STE 140",
"city": "DECATUR",
"state": "GA",
"postal_code": "300301722",
"telephone_number": "470-403-2830",
"fax_number": "470-427-5560"
}
],
"practiceLocations": [
{
"address_1": "225 Cedar Hill St Ste 200",
"address_purpose": "LOCATION",
"city": "Marlborough",
"state": "MA",
"postal_code": "017525900",
"country_code": "US",
"telephone_number": "857-829-4040",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "20 Marietta St NW Apt 5B",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303032822",
"country_code": "US",
"telephone_number": "516-983-3161",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROUSE",
"first_name": "ALYSSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-20",
"last_updated": "2021-05-19",
"certification_date": "2021-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BLUECROSS BLUESHIELD",
"identifier": "YLD84037016",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.