Avery Lynn Bundrick

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

209 Centre Sarcelle Blvd
Youngsville, LA 70592-6755

Phone

(337) 857-3674

NPI assigned

Dec 17, 2024

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 17, 2024.

{
    "created_epoch": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1821805409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "996 ROYAL MARCO WAY",
            "city": "MARCO ISLAND",
            "state": "FL",
            "postal_code": "341451829",
            "telephone_number": "818-345-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 CENTRE SARCELLE BLVD",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705926755",
            "telephone_number": "337-857-3674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNDRICK",
        "first_name": "AVERY",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-17",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Marie Broussard
• Taylor Paige Broussard
• Aaliyah Brown
• Megan Claire Bruno
• Hillarie Buck, CCC-SLP
• Jonathan Burbank, DDS
• Darian Jenne' Burke
• Keyonna Butler
• Stacy B Byler, MS, LDN, RD
• Madison Alexa Byrd

• All providers in Youngsville, LA
• Behavior Technician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.