Active NPI
Kyrah Chaelyn Harris
- Behavior Technician
- Durant, OK
National Provider Identifier
1043054307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB1134600
- Practice address
- 107 N 3Rd Ave
Durant, OK 74701-4700 - Phone
- (508) 706-6936
- NPI assigned
- Jun 21, 2024
- Sex
- Female
- Sole proprietor
- No
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 | BACB1134600 | OK | Primary |
Addresses
Primary practice location
107 N 3Rd Ave
Durant, OK 74701-4700
Mailing address
142 Elm Tree PL
Eminence, KY 40019-1170
Phone (502) 938-6208
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
| License | State | Type | Specialty |
|---|---|---|---|
| BACB1134600 | OK | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718928000000",
"number": "1043054307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "142 ELM TREE PL",
"city": "EMINENCE",
"state": "KY",
"postal_code": "400191170",
"telephone_number": "502-938-6208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 N 3RD AVE",
"city": "DURANT",
"state": "OK",
"postal_code": "747014700",
"telephone_number": "508-706-6936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "KYRAH",
"middle_name": "CHAELYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-21",
"last_updated": "2024-06-21",
"certification_date": "2024-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "OK",
"license": "BACB1134600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durant, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.