Active NPI
Khadajha Walker
- Behavior Technician
- Enterprise, AL
National Provider Identifier
1174192538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-21-171864
- Practice address
- 1247 Rucker Blvd Ste 3
Enterprise, AL 36330-3630 - Phone
- (334) 347-5003
- Fax
- (334) 440-8288
- NPI assigned
- Jun 21, 2021
- 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 | RBT-21-171864 | AL | Primary |
Addresses
Primary practice location
1247 Rucker Blvd Ste 3
Enterprise, AL 36330-3630
Mailing address
18 Evelyn Dr
Midland City, AL 36350-6260
Phone (334) 479-2529
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 |
|---|---|---|---|
| RBT-21-171864 | AL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624579200000",
"number": "1174192538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 EVELYN DR",
"city": "MIDLAND CITY",
"state": "AL",
"postal_code": "363506260",
"telephone_number": "334-479-2529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1247 RUCKER BLVD STE 3",
"city": "ENTERPRISE",
"state": "AL",
"postal_code": "363303630",
"telephone_number": "334-347-5003",
"fax_number": "334-440-8288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "KHADAJHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-21",
"last_updated": "2021-06-25",
"certification_date": "2021-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "AL",
"license": "RBT-21-171864",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Enterprise, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.