Active NPI
Audrey Baenziger, BCBA
- Behavior Analyst
- Kingston, IL
National Provider Identifier
1972058311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-15-20703
- Practice address
- 29854 Oak Meadow Dr
Kingston, IL 60145-8538 - Phone
- (815) 739-5244
- Fax
- (815) 895-2270
- NPI assigned
- Aug 15, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-15-20703 | IL | Primary |
Addresses
Primary practice location
29854 Oak Meadow Dr
Kingston, IL 60145-8538
Mailing address
29854 Oak Meadow Dr
Kingston, IL 60145-8538
Phone (815) 739-5244
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bright Minds Consulting LLC | Behavior Analyst | Current | Accepting new patients |
Organizations & group practices 1
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
- Kingston, IL
- NPI 1356165450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471219200000",
"number": "1972058311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29854 OAK MEADOW DR",
"city": "KINGSTON",
"state": "IL",
"postal_code": "601458538",
"telephone_number": "815-739-5244",
"fax_number": "815-895-2270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29854 OAK MEADOW DR",
"city": "KINGSTON",
"state": "IL",
"postal_code": "601458538",
"telephone_number": "815-739-5244",
"fax_number": "815-895-2270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAENZIGER",
"first_name": "AUDREY",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-15",
"last_updated": "2016-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IL",
"license": "1-15-20703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.