Individual provider Active NPI

Kylee Hiilani Enos

  • Behavior Analyst
  • Eugene, OR
National Provider Identifier
1073182630
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
COS-IC-10168366 Issued in OR
Practice address
2222 Martin Luther King Jr Blvd
Eugene, OR 97401-2475
Phone
(541) 224-6987
NPI assigned
Jun 18, 2021
Last updated
Jan 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X COS-IC-10168366 OR Primary

Addresses

Primary practice location

2222 Martin Luther King Jr Blvd
Eugene, OR 97401-2475

Mailing address

28 Fairway Loop
Eugene, OR 97401-2399
Phone (808) 271-4904

Other practice location 1

2490 Willamette St
Eugene, OR 97405-7210
Phone (503) 927-1179

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

LicenseStateTypeSpecialty
COS-IC-10168366ORMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
New Summit Behavioral Therapy, LLC Behavior Analyst PastSince Feb 4, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1073182630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 FAIRWAY LOOP",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012399",
            "telephone_number": "808-271-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 MARTIN LUTHER KING JR BLVD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012475",
            "telephone_number": "541-224-6987"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2490 Willamette St",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974057210",
            "country_code": "US",
            "telephone_number": "503-927-1179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENOS",
        "first_name": "KYLEE",
        "middle_name": "HIILANI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-18",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OR",
            "license": "COS-IC-10168366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.

Verify at the official NPI Registry.