Individual provider Active NPI

Ketaki Ruchika Singh Banerji

  • Behavior Technician
  • Dearborn, MI
National Provider Identifier
1043836307
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
15001 Michigan Ave
Dearborn, MI 48126-6600
Phone
(313) 689-5188
NPI assigned
Jun 23, 2020
Sex
Female
Sole proprietor
No

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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X MI Primary

Addresses

NPPES NPI Registry

Primary practice location

15001 Michigan Ave
Dearborn, MI 48126-6600

Mailing address

15001 Michigan Ave
Dearborn, MI 48126-6600

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 23, 2020.

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1043836307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15001 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481266600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15001 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481266600",
            "telephone_number": "313-689-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINGH BANERJI",
        "first_name": "KETAKI RUCHIKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.