NPIMap

Organization Active NPI

Southern Oregon ABA

  • Behavior Analyst
  • Central Point, OR
National Provider Identifier
1790295350
Registry record updated Oct 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
ABA-B-10175208 Issued in OR
Legal business name
SOUTHERN OREGON ABA
Practice address
2030 Taylor Rd
Central Point, OR 97502-1762
Phone
(541) 727-1592
Fax
(541) 664-3407
NPI assigned
Oct 9, 2017
Last updated
Oct 9, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2017

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

Authorized official

Name
Mrs. Nikole April McEwen, MS, BCBA, LBANPI 1356735112
Title
Clinical Director/Owner
Phone
(541) 727-1592

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X ABA-B-10175208 OR Primary

Addresses

Primary practice location

2030 Taylor Rd
Central Point, OR 97502-1762

Mailing address

2030 Taylor Rd
Central Point, OR 97502-1762
Phone (541) 727-1592

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507507200000",
    "number": "1790295350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 TAYLOR RD",
            "city": "CENTRAL POINT",
            "state": "OR",
            "postal_code": "975021762",
            "telephone_number": "541-727-1592",
            "fax_number": "541-664-3407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 TAYLOR RD",
            "city": "CENTRAL POINT",
            "state": "OR",
            "postal_code": "975021762",
            "telephone_number": "541-727-1592",
            "fax_number": "541-664-3407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OREGON ABA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-09",
        "last_updated": "2017-10-09",
        "status": "A",
        "authorized_official_last_name": "MCEWEN",
        "authorized_official_first_name": "NIKOLE",
        "authorized_official_middle_name": "APRIL",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/OWNER",
        "authorized_official_telephone_number": "541-727-1592",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OR",
            "license": "ABA-B-10175208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Central Point, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.