Active NPI
Samantha Ackerman, MS, BCBA
- Behavior Analyst
- Canton, GA
National Provider Identifier
1831663947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-23-64713
- Practice address
- 535 Riverstone Parkway Suite 101
Canton, GA 30114-2566 - Phone
- (855) 942-0995
- NPI assigned
- Jan 11, 2019
- Last updated
- Mar 16, 2023
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Behavior Technician | 106S00000X | |||
| Behavior Analyst | 103K00000X | 1-23-64713 | GA | Primary |
Addresses
Primary practice location
535 Riverstone Parkway Suite 101
Canton, GA 30114-2566
Mailing address
300 International Parkway Suite 200
Lake Mary, FL 32746-5028
Phone (866) 610-0580
Other practice location 1
7318 W Post Rd
Las Vegas, NV 89113-6644
Phone (800) 615-2361
Other practice location 2
725 S Mesa Hills Dr Bldg 3
El Paso, TX 79912-5568
Phone (915) 760-4147
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678924800000",
"number": "1831663947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 INTERNATIONAL PARKWAY SUITE 200",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327465028",
"telephone_number": "866-610-0580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "535 RIVERSTONE PARKWAY SUITE 101",
"city": "CANTON",
"state": "GA",
"postal_code": "301142566",
"telephone_number": "855-942-0995"
}
],
"practiceLocations": [
{
"address_1": "7318 W Post Rd",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891136644",
"country_code": "US",
"telephone_number": "800-615-2361",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "725 S Mesa Hills Dr Bldg 3",
"address_purpose": "LOCATION",
"city": "El Paso",
"state": "TX",
"postal_code": "799125568",
"country_code": "US",
"telephone_number": "915-760-4147",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ACKERMAN",
"first_name": "SAMANTHA",
"credential": "MS, BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-11",
"last_updated": "2023-03-16",
"certification_date": "2023-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "GA",
"license": "1-23-64713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.