Mohammad Edris Khaliqi Shuja, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1110 Herndon Pkwy Ste 305
Herndon, VA 20170-5547

Phone

(703) 943-6560

NPI assigned

Jun 15, 2023

Sex

Male

Sole proprietor

No

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 and National Provider Directory roles.

• Integrated Autism Behavior Services LLC

  • Behavior Analyst
  • Herndon, VA
  • NPI 1144951351
  NPD

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1053095356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13720 ATLANTIS ST APT 465",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201714176",
            "telephone_number": "202-340-9710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 HERNDON PKWY STE 305",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201705547",
            "telephone_number": "703-943-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIQI SHUJA",
        "first_name": "MOHAMMAD EDRIS",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Benjamin Keeton, DPT
• Katherine Kelley, COTA
• Ellen Meredith Kenst, DPT
• Rami Khaldieh, OD
• Sami Khaldieh, OD
• Gurusher Kaur Khalsa, M.ED., LPC
• Gurutrang Singh Khalsa, D.C.
• Sajjad A Khan, PHD, LCSW
• Isha Khosa, O.D.
• Alice Kim, M.S.W., L.C.S.W.

• Behavior Technician in Herndon, VA
• Providers in Herndon, VA by specialty
• Behavior Technician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.