Individual provider Active NPI

Ellie Kate Wooten

  • Behavior Technician
  • Shreveport, LA
National Provider Identifier
1891541058
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
7330 Fern Ave Ste 1103
Shreveport, LA 71105-4989
Phone
(318) 606-5706
NPI assigned
Apr 29, 2024
Last updated
Apr 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

7330 Fern Ave Ste 1103
Shreveport, LA 71105-4989

Mailing address

7330 Fern Ave Ste 1103
Shreveport, LA 71105-4989
Phone (318) 606-5706

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

OrganizationSpecialtyStatusNew patients
Sara Kate Warren, CCC-SLP, LLC CurrentSince May 7, 2024 Accepting new patients
Arklatex ABA, LLC CurrentSince May 7, 2024 Accepting new patients

Locations

7330 Fern Ave
Ste 1103
Shreveport, LA 71105
Phone (318) 264-8818

Organizations & group practices 2

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": "1714348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1891541058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7330 FERN AVE STE 1103",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054989",
            "telephone_number": "318-606-5706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7330 FERN AVE STE 1103",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054989",
            "telephone_number": "318-606-5706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOTEN",
        "first_name": "ELLIE",
        "middle_name": "KATE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.