Individual provider Active NPI

Jack Krizizke, RBT

  • Behavior Technician
  • Honolulu, HI
National Provider Identifier
1245841196
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
615 Piikoi St Ste 601
Honolulu, HI 96814-3176
Phone
(808) 868-9502
NPI assigned
Aug 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X HI Primary

Addresses

Primary practice location

615 Piikoi St Ste 601
Honolulu, HI 96814-3176

Mailing address

1330 Ala Moana Blvd Apt 1001
Honolulu, HI 96814-4202
Phone (808) 868-9502

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": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1245841196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 ALA MOANA BLVD APT 1001",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144202",
            "telephone_number": "808-868-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 PIIKOI ST STE 601",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143176",
            "telephone_number": "808-868-9502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIZIZKE",
        "first_name": "JACK",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-13",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "HI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; 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.