Active NPI
Kaitlin R Bender
- Behavior Technician
- Sartell, MN
National Provider Identifier
1194363002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 205 14TH Ave E
Sartell, MN 56377-4500 - Phone
- (320) 774-3436
- Fax
- (320) 774-3440
- NPI assigned
- Dec 11, 2019
- 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
205 14TH Ave E
Sartell, MN 56377-4500
Mailing address
108 Doctors Park
Saint Cloud, MN 56303-1207
Phone (320) 774-3915
Other practice location 1
108 Doctors Park
Saint Cloud, MN 56303-1207
Phone (320) 774-3915
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 |
|---|---|---|---|
| Northway Academy, Inc. | Past | Accepting new patients | |
| Northway Academy, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Developmental Disabilities Clinic/Center
- Saint Cloud, MN
- NPI 1104333715
-
- Community/Behavioral Health Agency
- Sartell, MN
- NPI 1841852639
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576022400000",
"number": "1194363002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 DOCTORS PARK",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563031207",
"telephone_number": "320-774-3915",
"fax_number": "320-774-3918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 14TH AVE E",
"city": "SARTELL",
"state": "MN",
"postal_code": "563774500",
"telephone_number": "320-774-3436",
"fax_number": "320-774-3440"
}
],
"practiceLocations": [
{
"address_1": "108 Doctors Park",
"address_purpose": "LOCATION",
"city": "Saint Cloud",
"state": "MN",
"postal_code": "563031207",
"country_code": "US",
"telephone_number": "320-774-3915",
"fax_number": "320-774-3918",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BENDER",
"first_name": "KAITLIN",
"middle_name": "R",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-11",
"last_updated": "2019-12-11",
"certification_date": "2019-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sartell, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.