Individual provider Active NPI

Stephanie Mepham

  • Behavior Analyst
  • Madison, WI
National Provider Identifier
1801514633
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
RBT-22-229518 Issued in WI
Practice address
3113 W Beltline Hwy Ste 300
Madison, WI 53713-2934
Phone
(224) 284-2240
Fax
(312) 893-2118
NPI assigned
Aug 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X RBT-22-229518 WI Primary

Addresses

Primary practice location

3113 W Beltline Hwy Ste 300
Madison, WI 53713-2934

Mailing address

1161 Lake Cook Rd
Deerfield, IL 60015-5649
Phone (224) 284-2240

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

LicenseStateTypeSpecialty
RBT-22-229518WIMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
KGH Consultation & Treatment, Inc. Behavior Analyst CurrentSince Aug 28, 2022 Accepting new patients

Locations

1161 Lake Cook Rd
Deerfield, IL 60015
Phone (224) 284-2240

3113 W Beltline Hwy
Ste 300
Madison, WI 53713
Phone (608) 819-6810

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1801514633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 LAKE COOK RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155649",
            "telephone_number": "224-284-2240",
            "fax_number": "312-893-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 W BELTLINE HWY STE 300",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537132934",
            "telephone_number": "224-284-2240",
            "fax_number": "312-893-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEPHAM",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WI",
            "license": "RBT-22-229518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.