Individual provider Active NPI

Charles Kodi Kransberger

  • Behavior Technician
  • Centennial, CO
National Provider Identifier
1295262426
Registry record updated May 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
BACB375979 Issued in CO
Practice address
6767 S Spruce St Ste 100
Centennial, CO 80112-6118
Phone
(303) 225-7673
NPI assigned
May 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2017

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 BACB375979 CO Primary

Addresses

Primary practice location

6767 S Spruce St Ste 100
Centennial, CO 80112-6118

Mailing address

543 18TH St Unit 204
Greeley, CO 80631-6035
Phone (608) 921-9417

Other identifiers 1

IdentifierTypeStateIssuer
BACB375979OtherCOBEHAVIOR ANALYST CERTIFICATION BOARD

Other names 1

  • NA NA Other name

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
BACB375979COMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495065600000",
    "number": "1295262426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "543 18TH ST UNIT 204",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806316035",
            "telephone_number": "608-921-9417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6767 S SPRUCE ST STE 100",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801126118",
            "telephone_number": "303-225-7673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRANSBERGER",
        "first_name": "CHARLES",
        "middle_name": "KODI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-18",
        "last_updated": "2017-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CO",
            "license": "BACB375979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR ANALYST CERTIFICATION BOARD",
            "identifier": "BACB375979",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NA",
            "last_name": "NA",
            "credential": "RBT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2017; 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.