Active NPI
Kierstyn Meissner
- Behavior Technician
- Midwest City, OK
National Provider Identifier
1104570407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 22-199866
- Practice address
- 1717 S Air Depot Blvd
Midwest City, OK 73110-5103 - Phone
- (405) 622-4239
- NPI assigned
- Feb 7, 2022
- 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 | 22-199866 | OK | Primary |
Addresses
Primary practice location
1717 S Air Depot Blvd
Midwest City, OK 73110-5103
Mailing address
1717 S Air Depot Blvd
Midwest City, OK 73110-5103
Phone (580) 280-1629
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | CR |
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 |
|---|---|---|---|
| 22-199866 | OK | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644192000000",
"number": "1104570407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 S AIR DEPOT BLVD",
"city": "MIDWEST CITY",
"state": "OK",
"postal_code": "731105103",
"telephone_number": "580-280-1629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 S AIR DEPOT BLVD",
"city": "MIDWEST CITY",
"state": "OK",
"postal_code": "731105103",
"telephone_number": "405-622-4239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEISSNER",
"first_name": "KIERSTYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-07",
"last_updated": "2022-02-07",
"certification_date": "2022-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "OK",
"license": "22-199866",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "CR",
"affiliation": "N",
"address_1": "1717 S Air Depot Blvd",
"city": "Midwest City",
"state": "OK",
"country_code": "US",
"postal_code": "731105103",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Midwest City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.