Individual provider Active NPI

Gema Bautista Morris, BCBA, LBA

  • Behavior Analyst
  • Troy, MI
National Provider Identifier
1821589532
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
7401001610 Issued in MI
Practice address
2032 E Square Lake Rd Ste 100
Troy, MI 48085-3315
Phone
(248) 825-3607
NPI assigned
May 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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 7401001610 MI Primary

Addresses

Primary practice location

2032 E Square Lake Rd Ste 100
Troy, MI 48085-3315

Mailing address

1047 Arthur Dr
Troy, MI 48083-1802
Phone (517) 442-3127

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
7401001610MIMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Dakroub LLC. Behavior Analyst Past Accepting new patients

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": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1821589532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1047 ARTHUR DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831802",
            "telephone_number": "517-442-3127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2032 E SQUARE LAKE RD STE 100",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480853315",
            "telephone_number": "248-825-3607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA MORRIS",
        "first_name": "GEMA",
        "credential": "BCBA, LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-29",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "7401001610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.