Blue Gems ABA Mo LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

BLUE GEMS ABA MO LLC

Practice address

800 E 101St Ter Ste 350
Kansas City, MO 64131-5310

Phone

(816) 371-4180

Fax

(617) 340-3371

NPI assigned

Jun 12, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Wolf

Title

Ceo

Phone

(617) 297-7998

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721260800000",
    "number": "1871277632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E 101ST TER STE 350",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641315310",
            "telephone_number": "617-297-7998",
            "fax_number": "617-340-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 101ST TER STE 350",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641315310",
            "telephone_number": "816-371-4180",
            "fax_number": "617-340-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE GEMS ABA MO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-12",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "617-297-7998"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.