Individual provider Active NPI

Cara Elise Manke, BCBA

  • Behavior Analyst
  • Springfield, IL
National Provider Identifier
1972003358
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-23-69866
Practice address
3921 Pintail Dr Ste B
Springfield, IL 62711-6738
Phone
(502) 297-0133
NPI assigned
Feb 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-16-26842 IL
Behavior Analyst 103K00000X 1-23-69866 Primary

Addresses

Primary practice location

3921 Pintail Dr Ste B
Springfield, IL 62711-6738

Mailing address

3921 Pintail Dr Ste B
Springfield, IL 62711-6738
Phone (502) 297-0133

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

LicenseStateTypeSpecialty
RBT-16-26842ILMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1972003358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3921 PINTAIL DR STE B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627116738",
            "telephone_number": "502-297-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 PINTAIL DR STE B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627116738",
            "telephone_number": "502-297-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANKE",
        "first_name": "CARA",
        "middle_name": "ELISE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-13",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": "RBT-16-26842",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-23-69866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; 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.