Tyra Renee Du Bose

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

555 Fraser Ave
Lanai City, HI 96763-1774

Phone

(808) 649-0869

NPI assigned

Jul 28, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Tyra Renee Knox Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1285187971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631774",
            "city": "LANAI CITY",
            "state": "HI",
            "postal_code": "967631774",
            "telephone_number": "808-649-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 FRASER AVE",
            "city": "LANAI CITY",
            "state": "HI",
            "postal_code": "967631774",
            "telephone_number": "808-649-0869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DU BOSE",
        "first_name": "TYRA",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-28",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "HI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TYRA",
            "last_name": "KNOX",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alicia Marie Bennett, MS, ATC, CPFS
• Bio-Medical Applications of California, Inc. (FMC Lanai Community Dialysis Center)
• Jamie Kamailani Boyd, FNP
• Karen Brown, LMT
• Dept. of Health-Hawaii-Child and Adolescent Mental Health Division
• Marivic Abarra Elaydo, RBT
• Michele Ann Evangelista, MASSAGE THERAPIST
• Reynold Masaji Gima, MSC
• Nora Kay Harmsen, DDS
• Hawaii Dental Clinic Lanai

• Behavior Analyst in Lanai City, HI
• Providers in Lanai City, HI by specialty
• Behavior Analyst in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; 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.