Individual provider Active NPI

Colleen Olds

  • Behavior Technician
  • Anchorage, AK
National Provider Identifier
1194344127
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
4000 San Ernesto Ave
Anchorage, AK 99508-2874
Phone
(907) 729-6351
NPI assigned
Apr 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Day Training/Habilitation Specialist 373H00000X
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

4000 San Ernesto Ave
Anchorage, AK 99508-2874

Mailing address

4000 San Ernesto Ave
Anchorage, AK 99508-2874
Phone (907) 729-6351

Other practice location 1

7521 Brayton Dr
Anchorage, AK 99507-2667
Phone (907) 929-5782

Other identifiers 1

IdentifierTypeStateIssuer
NAOtherN/A

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Anchorage

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

NPI Registry JSON

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1194344127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 SAN ERNESTO AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082874",
            "telephone_number": "907-729-6351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 SAN ERNESTO AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082874",
            "telephone_number": "907-729-6351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7521 Brayton Dr",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995072667",
            "country_code": "US",
            "telephone_number": "907-929-5782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLDS",
        "first_name": "COLLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-09",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Anchorage",
            "affiliation": "N",
            "address_1": "7521 Brayton Dr",
            "city": "Anchorage",
            "state": "AK",
            "country_code": "US",
            "postal_code": "995072667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.

Verify at the official NPI Registry.