Individual provider Active NPI

Kaitlyn Kudrna

  • Behavior Analyst
  • Bismarck, ND
National Provider Identifier
1255839122
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
L54 Issued in ND
Practice address
806 N Washington St
Bismarck, ND 58501-3623
Phone
(701) 355-3000
NPI assigned
Jan 25, 2018
Last updated
Aug 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X L54 ND Primary
Behavior Technician 106S00000X RBT-18-47348 ND

Addresses

Primary practice location

806 N Washington St
Bismarck, ND 58501-3623

Mailing address

806 N Washington St
Bismarck, ND 58501-3623

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

LicenseStateTypeSpecialty
L54NDMDBehavioral Analyst
RBT-18-47348NDMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1516838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1255839122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 N WASHINGTON ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585013623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 N WASHINGTON ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585013623",
            "telephone_number": "701-355-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDRNA",
        "first_name": "KAITLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-25",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "ND",
            "license": "L54",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "ND",
            "license": "RBT-18-47348",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.