Active NPI
Ciara Rayne Petrash
- Behavior Technician
- Colorado Springs, CO
National Provider Identifier
1306334263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 6189 Lehman Dr Ste 202
Colorado Springs, CO 80918-5409 - Phone
- (719) 266-1000
- NPI assigned
- Apr 26, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
6189 Lehman Dr Ste 202
Colorado Springs, CO 80918-5409
Mailing address
16111 Old Forest PT Apt 100
Monument, CO 80132-8675
Other names 1
- Ciara Rayne McKenzie
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": "1524700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539475200000",
"number": "1306334263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16111 OLD FOREST PT APT 100",
"city": "MONUMENT",
"state": "CO",
"postal_code": "801328675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6189 LEHMAN DR STE 202",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809185409",
"telephone_number": "719-266-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRASH",
"first_name": "CIARA",
"middle_name": "RAYNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-26",
"last_updated": "2018-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CIARA",
"last_name": "MCKENZIE",
"middle_name": "RAYNE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.