Active NPI
Megan Michelle Macneil
- Behavior Technician
- Idaho Falls, ID
National Provider Identifier
1790353035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 938 Poulson St
Idaho Falls, ID 83401-2142 - Phone
- (501) 513-7638
- NPI assigned
- Jun 14, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | ID | Primary |
Addresses
Primary practice location
938 Poulson St
Idaho Falls, ID 83401-2142
Mailing address
3653 Hidden Haven St
Ammon, ID 83406-7509
Phone (501) 513-7638
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106S00000X | Medicaid | ID |
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": "1623628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623628800000",
"number": "1790353035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3653 HIDDEN HAVEN ST",
"city": "AMMON",
"state": "ID",
"postal_code": "834067509",
"telephone_number": "501-513-7638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "938 POULSON ST",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834012142",
"telephone_number": "501-513-7638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACNEIL",
"first_name": "MEGAN",
"middle_name": "MICHELLE",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-14",
"last_updated": "2021-06-14",
"certification_date": "2021-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "ID",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "106S00000X",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.