Kelly Trutter, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

5221 6TH Street Frontage Rd E
Springfield, IL 62703-5190

Phone

(916) 752-3961

NPI assigned

May 6, 2010

Last updated

Feb 24, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Clover Solutions LLC

  • Behavior Analyst
  • Springfield, IL
  • NPI 1144814773
  NPD Authorized official

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

{
    "created_epoch": "1273104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1891013470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 CULPEPPER WAY",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956487833",
            "telephone_number": "916-752-3961",
            "fax_number": "916-543-6470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5221 6TH STREET FRONTAGE RD E",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627035190",
            "telephone_number": "916-752-3961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUTTER",
        "first_name": "KELLY",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-06",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Joy Trower, OTR/L
• Bart L Troy, M.D.
• Edward A Trudeau, M.D.
• True Light Wellness
• True Roots Chiropractic & Wellness PLLC
• Celina C Tsang, M.D.
• Bethany L Tschantz, FNP-BC
• Kevin Tu, DO
• Carrie S. Tucker, NURSE PRACTITIONER
• Christina Kay Tucker, FNP-BC

• Behavior Analyst in Springfield, IL
• Providers in Springfield, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.