NPIMap

Individual provider Active NPI

Della M Radke, QMHA

  • Behavior Analyst
  • Salem, OR
National Provider Identifier
1003246653
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
4890 32ND Ave SE
Salem, OR 97317-9350
Phone
(503) 588-5647
Fax
(503) 588-0509
NPI assigned
Nov 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary
Community Health Worker 172V00000X

Addresses

Primary practice location

4890 32ND Ave SE
Salem, OR 97317-9350

Mailing address

4890 32ND Ave SE
Salem, OR 97317-9350
Phone (503) 588-5647

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

OrganizationSpecialtyStatusNew patients
Christian Community Placement Center Past Accepting new patients
Christian Community Placement Center Past Accepting new patients

Organizations & group practices 2

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": "1384819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1003246653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4890 32ND AVE SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973179350",
            "telephone_number": "503-588-5647",
            "fax_number": "503-588-0509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4890 32ND AVE SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973179350",
            "telephone_number": "503-588-5647",
            "fax_number": "503-588-0509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADKE",
        "first_name": "DELLA",
        "middle_name": "M",
        "credential": "QMHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-19",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; 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.