Active NPI
Emma E Pettingill, BCBA
- Behavior Analyst
- Austin, TX
National Provider Identifier
1790149508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1033
- Practice address
- 11623 Angus Rd Ste E20
Austin, TX 78759 - Phone
- (512) 827-7011
- NPI assigned
- Apr 7, 2016
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-16-21495 | TX | |
| Behavior Analyst | 103K00000X | 1033 | TX | Primary |
Addresses
Primary practice location
11623 Angus Rd Ste E20
Austin, TX 78759
Mailing address
11623 Angus Rd Ste E20
Austin, TX 78759-4003
Phone (512) 827-7011
Other names 1
- Emma E Henson
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 |
|---|---|---|---|
| 1033 | TX | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Texas Autism Center, LLC | Behavior Analyst | Past | Accepting new patients |
| Building Blocs (Behavior and Language Opportunities for Communication | 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 and National Provider Directory roles.
-
dba Building BLOCS
- Behavior Analyst
- Austin, TX
- NPI 1376857870
-
- Behavior Analyst
- Austin, TX
- NPI 1053472035
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555372800000",
"number": "1790149508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11623 ANGUS RD STE E20",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787594003",
"telephone_number": "512-827-7011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11623 ANGUS RD STE E20",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78759",
"telephone_number": "512-827-7011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTINGILL",
"first_name": "EMMA",
"middle_name": "E",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-07",
"last_updated": "2019-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "1-16-21495",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "1033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "EMMA",
"last_name": "HENSON",
"middle_name": "E",
"credential": "BCBA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.