Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1891286787 Deactivated / Inactive NPI Male Practitioner

Mark Bopp

Behavior Technician • House Springs, MO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Mark Bopp has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 25, 2018
NPI Deactivation Date February 28, 2023
Total Practice Duration ~5 Years of Practice (2018 – 2023)

Professional Overview & Biography Verified Profile Summary

Mark Bopp was a registered Behavior Technician practicing in House Springs, MO. Throughout an active medical career spanning 5 years, Mark Bopp provided care at the practice location at 4400 KENNERLY PARK RD until profile deactivation on 2023-02-28.

Practice Location & Contact Primary Location

Practice Address

4400 Kennerly Park Rd

House Springs, MO 630514342

Telephone 6366926831
Associated Practice Facility / Clinic
🏢 Judevine, Inc. Facility NPI 1518291418

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Technician in House Springs, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
2 Specialists

Practicing in House Springs, MO (3729 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Behavior Technician Primary Specialty

NUCC Taxonomy Code: 106S00000X

The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Jessica Harralston

Behavior Technician

NPI 1609368216

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
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NPI Profile Deactivated February 28, 2023

Record deactivated on February 28, 2023

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Updated Practice Location September 15, 2020

Registered at 16375 PIERSIDE LN, WILDWOOD, MO 630401600 (Tel: 3145414652)

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Updated Practice Location April 25, 2020

Registered at 1759 LYON RD, NEW HAVEN, MO 630682632 (Tel: 3145414652)

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Updated Business Mailing Address April 25, 2020

Registered at 1759 LYON RD, NEW HAVEN, MO 630682632

NPI Profile Active May 25, 2018

NPI status registered as active in NPPES database

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Updated Practice Location May 25, 2018

Registered at 4400 KENNERLY PARK RD, HOUSE SPRINGS, MO 630514342 (Tel: 6366926831)

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Updated Business Mailing Address May 25, 2018

Registered at 1810 CRAIG RD STE 109, SAINT LOUIS, MO 631464758

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Provider Name / Credentials Updated May 25, 2018

Recorded as MARK BOPP

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 25, 2018

Behavior Technician

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Initial NPI Registration & Enumeration May 25, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1891286787
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 25, 2018
Last Update: May 25, 2018
Deactivation Date: February 28, 2023

Mailing Address

1810 Craig Rd Ste 109

Saint Louis, MO 631464758

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.