Saleh Botan

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

6260 Highway 65 NE Ste 303
Fridley, MN 55432-5150

Phone

(614) 218-3069

NPI assigned

Oct 26, 2023

Last updated

Oct 26, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Empower Skill Academy LLC

  • Clinic/Center
  • Fridley, MN
  • NPI 1689305443
  NPD

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

{
    "created_epoch": "1698278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1033981642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14352 SORREL WAY",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553471682",
            "telephone_number": "612-363-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6260 HIGHWAY 65 NE STE 303",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554325150",
            "telephone_number": "614-218-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTAN",
        "first_name": "SALEH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-26",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Paul Bondhus
• Hana Bonefacic, M.D
• Henry Kah Min Bong, MD
• Lori Patricia Borchardt, RPH
• Jenna Borkenhagen
• Alexander Talbot Boyer
• Brainz LLC
• Joseph Michael Brandt, DO
• Kathrine Linn Brathen, MA, L.P.
• Ashley Brausen, DPT

• Behavior Technician in Fridley, MN
• Providers in Fridley, MN by specialty
• Behavior Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.