Individual provider Active NPI

Brandee Lynn Masterson

  • Behavior Analyst
  • Southaven, MS
National Provider Identifier
1962751933
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
6858 Swinnea Rd BLDG 6B
Southaven, MS 38671-9493
Phone
(662) 426-6136
Fax
(662) 499-6136
NPI assigned
Sep 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

6858 Swinnea Rd BLDG 6B
Southaven, MS 38671-9493

Mailing address

2068 Evelyn Ave
Memphis, TN 38104-5416
Phone (731) 234-1873

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
Upward ABA Behavior Analyst CurrentSince Oct 10, 2021 Accepting new patients
Up-Ward ABA CurrentSince Oct 10, 2021 Accepting new patients

Locations

6858 Swinnea Rd
Bldg 6B
Southaven, MS 38671
Phone (626) 426-6136

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.

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1962751933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2068 EVELYN AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381045416",
            "telephone_number": "731-234-1873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6858 SWINNEA RD BLDG 6B",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719493",
            "telephone_number": "662-426-6136",
            "fax_number": "662-499-6136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTERSON",
        "first_name": "BRANDEE",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.