Individual provider Active NPI

Kyle E Bringmann, RBT

  • Behavior Technician
  • Augusta, GA
National Provider Identifier
1982275152
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
20-120111 Issued in GA
Practice address
2945 Walton Way
Augusta, GA 30909-3827
Phone
(706) 842-3279
Fax
(706) 842-3272
NPI assigned
Jul 8, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 20-120111 GA Primary

Addresses

Primary practice location

2945 Walton Way
Augusta, GA 30909-3827

Mailing address

2945 Walton Way
Augusta, GA 30909-3827
Phone (706) 842-3279

Other identifiers 1

IdentifierTypeStateIssuer
20-120111OtherGABEHAVIORAL TECHNICIAN

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
20-120111GAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Autism Clinical & Evaluation Services LLC Behavior Technician CurrentSince Jul 17, 2021 Accepting new patients

Locations

2945 Walton Way Ext
Augusta, GA 30909
Phone (706) 434-0421

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.

NPI Registry JSON

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1982275152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2945 WALTON WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309093827",
            "telephone_number": "706-842-3279",
            "fax_number": "706-842-3272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 WALTON WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309093827",
            "telephone_number": "706-842-3279",
            "fax_number": "706-842-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINGMANN",
        "first_name": "KYLE",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "20-120111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIORAL TECHNICIAN",
            "identifier": "20-120111",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.