Active NPI
Brendon Kyle Walter Proffitt
- Behavior Technician
- Albuquerque, NM
National Provider Identifier
1003729617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1208 Lead Ave SE
Albuquerque, NM 87106-5217 - Phone
- (505) 302-1619
- NPI assigned
- Sep 24, 2026
- Last updated
- Sep 24, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
1208 Lead Ave SE
Albuquerque, NM 87106-5217
Mailing address
1208 Lead Ave SE
Albuquerque, NM 87106-5217
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790208000000",
"number": "1003729617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1208 LEAD AVE SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871065217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1208 LEAD AVE SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871065217",
"telephone_number": "505-302-1619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROFFITT",
"first_name": "BRENDON",
"middle_name": "KYLE WALTER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-09-24",
"last_updated": "2026-09-24",
"certification_date": "2026-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Albuquerque, NM
- Kathleen Ynez Proctor, M.S., CCC-SLP
- Carl C. Profazi, D.D.S.
- Professional Case Coordination and Consultation Inc
- Professional Case Coordination Services LLC
- Professional Wound Specialists PLLC
- Trent Lee Proffitt, M.D.
- Erica Prokopich, NP-C
- Prospera Healthcare New Mexico LLC
- Tony Jacinto Prosser, PHARMD
- Prosthetic Orthotic Specialists, Inc (Center for Prosthetic & Orthotic Design)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.