Individual provider Active NPI

Taylor Lynn Buldra, MS, BCBA

  • Behavior Analyst
  • Bentonville, AR
National Provider Identifier
1891367975
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-23-67243
Practice address
2703 SE Otis Corley Dr Ste 11
Bentonville, AR 72712-3414
Phone
(479) 339-9678
Fax
(317) 520-8200
NPI assigned
Jul 16, 2021
Sex
Female
Sole proprietor
No

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

State licenses

LicenseStateTypeSpecialty
RBT-21-152383ILMDBehavior Technician

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-21-152383 IL
Behavior Analyst 103K00000X 1-23-67243 Primary

Addresses

NPPES NPI Registry

Primary practice location

2703 SE Otis Corley Dr Ste 11
Bentonville, AR 72712-3414

Mailing address

1725 S Naperville Rd
Wheaton, IL 60189-5805
Phone (630) 793-8404

Other practice location 1

1725 S Naperville Rd Ste 110
Wheaton, IL 60189-5855
Phone (630) 793-8404

Other practice location 2

4610 W Commercial Dr
North Little Rock, AR 72116-7057
Phone (501) 287-5229

Other names 1

NPPES NPI Registry
  • Taylor Lynn Shulz Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 13, 2025.

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1891367975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 S NAPERVILLE RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601895805",
            "telephone_number": "630-793-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2703 SE OTIS CORLEY DR STE 11",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123414",
            "telephone_number": "479-339-9678",
            "fax_number": "317-520-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1725 S Naperville Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Wheaton",
            "state": "IL",
            "postal_code": "601895855",
            "country_code": "US",
            "telephone_number": "630-793-8404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4610 W Commercial Dr",
            "address_purpose": "LOCATION",
            "city": "North Little Rock",
            "state": "AR",
            "postal_code": "721167057",
            "country_code": "US",
            "telephone_number": "501-287-5229",
            "fax_number": "317-520-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULDRA",
        "first_name": "TAYLOR",
        "middle_name": "LYNN",
        "credential": "MS, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-16",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": "RBT-21-152383",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-23-67243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "SHULZ",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; 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.