Active NPI
Kinley Dickson
- Behavior Technician
- Indianapolis, IN
National Provider Identifier
1194522607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 22-206632
- Practice address
- 5155 Pennwood Dr
Indianapolis, IN 46205-1585 - Phone
- (317) 571-1042
- NPI assigned
- Mar 3, 2025
- 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 | 22-206632 | IN | Primary |
Addresses
Primary practice location
5155 Pennwood Dr
Indianapolis, IN 46205-1585
Mailing address
5155 Pennwood Dr
Indianapolis, IN 46205-1585
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 |
|---|---|---|---|
| 22-206632 | IN | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tangram, Inc. | Past | Accepting new patients |
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.
-
- Behavior Analyst
- Indianapolis, IN
- NPI 1912950700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740960000000",
"number": "1194522607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5155 PENNWOOD DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462051585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5155 PENNWOOD DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462051585",
"telephone_number": "317-571-1042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKSON",
"first_name": "KINLEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-03",
"last_updated": "2025-03-03",
"certification_date": "2025-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IN",
"license": "22-206632",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.