Individual provider Active NPI

Taylor Marquardt, MS, BCBA

  • Behavior Analyst
  • Bloomington, MN
National Provider Identifier
1245801158
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-23-66146
Practice address
1801 American Blvd E Ste 8
Bloomington, MN 55425-1230
Phone
(952) 767-2267
NPI assigned
Jul 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-21-169712 WI
Behavior Analyst 103K00000X 1-23-66146 Primary

Addresses

Primary practice location

1801 American Blvd E Ste 8
Bloomington, MN 55425-1230

Mailing address

1801 American Blvd E Ste 8
Bloomington, MN 55425-1230
Phone (952) 767-2267

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
RBT-21-169712WIMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Fraser Child and Family Center CurrentSince Oct 9, 2023 Accepting new patients
Fraser PastSince Sep 10, 2023 Accepting new patients
KGH Consultation & Treatment, Inc. Behavior Analyst PastSince Jul 1, 2021 Accepting new patients

Locations

1801 American Blvd E
Ste 8
Minneapolis, MN 55425
Phone (612) 400-6173

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1245801158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 AMERICAN BLVD E STE 8",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251230",
            "telephone_number": "952-767-2267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 AMERICAN BLVD E STE 8",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251230",
            "telephone_number": "952-767-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUARDT",
        "first_name": "TAYLOR",
        "credential": "MS, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-02",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WI",
            "license": "RBT-21-169712",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-23-66146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.