Active NPI
Kimberly Brogdon Waldrop, BCBA
- Behavior Analyst
- Temple, GA
National Provider Identifier
1851802805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-17-26975
- Practice address
- 2755 Carrollton Hwy
Temple, GA 30179-4920 - Phone
- (404) 275-0514
- NPI assigned
- Oct 17, 2017
- Last updated
- Oct 17, 2017
- 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 | 1-17-26975 | NU | Primary |
Addresses
Primary practice location
2755 Carrollton Hwy
Temple, GA 30179-4920
Mailing address
2755 Carrollton Hwy
Temple, GA 30179-4920
Phone (404) 275-0514
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 |
|---|---|---|---|
| ABA Twenty-Nine Eleven LLC | Behavior Analyst | Current | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508198400000",
"number": "1851802805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2755 CARROLLTON HWY",
"city": "TEMPLE",
"state": "GA",
"postal_code": "301794920",
"telephone_number": "404-275-0514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2755 CARROLLTON HWY",
"city": "TEMPLE",
"state": "GA",
"postal_code": "301794920",
"telephone_number": "404-275-0514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDROP",
"first_name": "KIMBERLY",
"middle_name": "BROGDON",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-17",
"last_updated": "2017-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NU",
"license": "1-17-26975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temple, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.