Active NPI
Kaylea Holt
- Behavior Technician
- Hermantown, MN
National Provider Identifier
1043913064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 4140 Richard Ave
Hermantown, MN 55811-2869 - Phone
- (218) 520-3411
- NPI assigned
- Mar 27, 2023
- 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 | MN | Primary |
Addresses
Primary practice location
4140 Richard Ave
Hermantown, MN 55811-2869
Mailing address
4140 Richard Ave
Hermantown, MN 55811-2869
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588993091 | Medicaid | MN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | hrhelp@caravelautism.com | Direct |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679875200000",
"number": "1043913064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4140 RICHARD AVE",
"city": "HERMANTOWN",
"state": "MN",
"postal_code": "558112869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4140 RICHARD AVE",
"city": "HERMANTOWN",
"state": "MN",
"postal_code": "558112869",
"telephone_number": "218-520-3411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLT",
"first_name": "KAYLEA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-27",
"last_updated": "2023-03-27",
"certification_date": "2023-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MN",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1588993091",
"state": "MN"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "hrhelp@caravelautism.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "4140 Richard Ave",
"city": "Hermantown",
"state": "MN",
"country_code": "US",
"postal_code": "558112869",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Hermantown, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.