Individual provider Active NPI

Brandy L Wilson

  • Behavior Analyst
  • Kansas City, MO
National Provider Identifier
1992368658
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
2016035610 Issued in MO
Practice address
1460 NW Vivion Rd Ste B
Kansas City, MO 64118-4555
Phone
(816) 853-0946
Fax
(816) 396-8809
NPI assigned
Apr 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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 2016035610 MO Primary

Addresses

Primary practice location

1460 NW Vivion Rd Ste B
Kansas City, MO 64118-4555

Mailing address

1460 NW Vivion Rd Ste B
Kansas City, MO 64118-4555
Phone (816) 853-0946

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
2016035610MOMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1992368658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 NW VIVION RD STE B",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641184555",
            "telephone_number": "816-853-0946",
            "fax_number": "816-396-8809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 NW VIVION RD STE B",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641184555",
            "telephone_number": "816-853-0946",
            "fax_number": "816-396-8809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRANDY",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "2016035610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; 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.