Active NPI
Nicole Cooper, RBT
- Behavior Analyst
- Henderson, KY
National Provider Identifier
1962086231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-22-59403
- Practice address
- 724 Barret Blvd Ste a
Henderson, KY 42420-4931 - Phone
- (270) 827-4652
- Fax
- (615) 815-1946
- NPI assigned
- May 12, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-19-98765 | IN | |
| Behavior Analyst | 103K00000X | 1-22-59403 | IN | Primary |
Addresses
Primary practice location
724 Barret Blvd Ste a
Henderson, KY 42420-4931
Mailing address
1321 Murfreesboro Pike Ste 702
Nashville, TN 37217-2679
Phone (615) 361-4000
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-19-98765 | IN | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mysa Autism Center LLC | Past | Accepting new patients | |
| Growing Minds Learning Center, LLC | Behavior Analyst | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Behavior Analyst
- Bowling Green, KY
- NPI 1275813222
-
- Developmentally Disabled Services Day Training Agency
- Evansville, IN
- NPI 1831943364
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652832000000",
"number": "1962086231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1321 MURFREESBORO PIKE STE 702",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372172679",
"telephone_number": "615-361-4000",
"fax_number": "615-815-1946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "724 BARRET BLVD STE A",
"city": "HENDERSON",
"state": "KY",
"postal_code": "424204931",
"telephone_number": "270-827-4652",
"fax_number": "615-815-1946"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "NICOLE",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-12",
"last_updated": "2022-05-18",
"certification_date": "2022-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IN",
"license": "RBT-19-98765",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IN",
"license": "1-22-59403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.