Individual provider Active NPI

Kaitlyn Lea Schares, BCBA, LBA

  • Behavior Analyst
  • Hiawatha, IA
National Provider Identifier
1972119337
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
101032 Issued in IA
Practice address
1661 Boyson Square Dr
Hiawatha, IA 52233-2344
Phone
(319) 830-5940
NPI assigned
Sep 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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 101032 IA Primary

Addresses

Primary practice location

1661 Boyson Square Dr
Hiawatha, IA 52233-2344

Mailing address

418 5TH Ave SE
Independence, IA 50644-2936
Phone (319) 830-5940

Other identifiers 2

IdentifierTypeStateIssuer
101032OtherIAIOWA LICENSURE
1-20-43382OtherBACB (BEHAVIOR ANALYST CERTIFICATION BOARD)

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
101032IAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1972119337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 5TH AVE SE",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506442936",
            "telephone_number": "319-830-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 BOYSON SQUARE DR",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522332344",
            "telephone_number": "319-830-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHARES",
        "first_name": "KAITLYN",
        "middle_name": "LEA",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IA",
            "license": "101032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA LICENSURE",
            "identifier": "101032",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BACB (BEHAVIOR ANALYST CERTIFICATION BOARD)",
            "identifier": "1-20-43382",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiawatha, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.