Active NPI
Amber L Trotta
- Behavior Analyst
- Grain Valley, MO
National Provider Identifier
1801468624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-21-51373
- Practice address
- 912 SW Foxtail Dr
Grain Valley, MO 64029-9111 - Phone
- (816) 305-6633
- NPI assigned
- Jul 12, 2021
- Last updated
- Jul 12, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-21-51373 | MO | Primary |
Addresses
Primary practice location
912 SW Foxtail Dr
Grain Valley, MO 64029-9111
Mailing address
912 SW Foxtail Dr
Grain Valley, MO 64029-9111
Phone (816) 305-6633
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103K00000X | Medicaid | MO | |
| 1-21-51373 | Medicaid | MO |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Supportive Care ABA VA LLC | Behavior Analyst | Past | Accepting new patients |
| The Itd Group LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- McLean, VA
- NPI 1053034231
Behavior Analyst
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626048000000",
"number": "1801468624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "912 SW FOXTAIL DR",
"city": "GRAIN VALLEY",
"state": "MO",
"postal_code": "640299111",
"telephone_number": "816-305-6633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "912 SW FOXTAIL DR",
"city": "GRAIN VALLEY",
"state": "MO",
"postal_code": "640299111",
"telephone_number": "816-305-6633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TROTTA",
"first_name": "AMBER",
"middle_name": "L",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-12",
"last_updated": "2021-07-12",
"certification_date": "2021-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MO",
"license": "1-21-51373",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103K00000X",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1-21-51373",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grain Valley, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.