Active NPI
Courtney Kennedy, RBT
- Other Technician
- Irving, TX
National Provider Identifier
1871077313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- RBT-18-60710
- Practice address
- 3100 Premier Dr Ste 234
Irving, TX 75063-2693 - Phone
- (972) 756-1222
- Fax
- (469) 374-0800
- NPI assigned
- Sep 20, 2018
- 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 |
|---|---|---|---|---|
| Other Technician | 247200000X | RBT-18-60710 | TX | Primary |
Addresses
Primary practice location
3100 Premier Dr Ste 234
Irving, TX 75063-2693
Mailing address
3100 Premier Dr Ste 234
Irving, TX 75063-2693
Phone (972) 756-1222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RBT-18-60710 | Other | TX | BACB |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-18-60710 | TX | MD | Other Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Monarch Behavioral Therapy Bii, LLC | 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.
-
- Behavior Analyst
- Columbia, MD
- NPI 1043456296
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537401600000",
"number": "1871077313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 PREMIER DR STE 234",
"city": "IRVING",
"state": "TX",
"postal_code": "750632693",
"telephone_number": "972-756-1222",
"fax_number": "469-374-0800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 PREMIER DR STE 234",
"city": "IRVING",
"state": "TX",
"postal_code": "750632693",
"telephone_number": "972-756-1222",
"fax_number": "469-374-0800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "COURTNEY",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-20",
"last_updated": "2018-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "TX",
"license": "RBT-18-60710",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BACB",
"identifier": "RBT-18-60710",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.