Active NPI
Shakeya Miller
- Behavior Technician
- Randallstown, MD
National Provider Identifier
1144826116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 9922 Liberty Rd
Randallstown, MD 21133-1804 - Phone
- (443) 657-3345
- NPI assigned
- Dec 7, 2020
- 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 | Primary |
Addresses
Primary practice location
9922 Liberty Rd
Randallstown, MD 21133-1804
Mailing address
2308 Ashburton St
Baltimore, MD 21216-2911
Phone (443) 985-3374
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kiddie Koach PRP LLC. | Current | Accepting new patients |
Locations
9922 Liberty Rd
Randallstown, MD 21133
Phone (443) 657-3345
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Randallstown, MD
- NPI 1376000158
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607299200000",
"number": "1144826116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2308 ASHBURTON ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212162911",
"telephone_number": "443-985-3374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9922 LIBERTY RD",
"city": "RANDALLSTOWN",
"state": "MD",
"postal_code": "211331804",
"telephone_number": "443-657-3345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "SHAKEYA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-07",
"last_updated": "2020-12-07",
"certification_date": "2020-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Randallstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.