Individual provider Active NPI

Krystle Lynn Hedrick, MED, BCBA

  • Behavior Analyst
  • Herndon, VA
National Provider Identifier
1326321696
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-10-7868 Issued in VA
Practice address
626 Grant St Ste I
Herndon, VA 20170-4700
Phone
(703) 999-4550
NPI assigned
Sep 23, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-10-7868 VA Primary

Addresses

Primary practice location

626 Grant St Ste I
Herndon, VA 20170-4700

Mailing address

626 Grant St Ste I
Herndon, VA 20170-4700
Phone (703) 999-4550

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
Credentials
Master of Education

NPI Registry JSON

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

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1326321696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 GRANT ST STE I",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704700",
            "telephone_number": "703-999-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 GRANT ST STE I",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704700",
            "telephone_number": "703-999-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDRICK",
        "first_name": "KRYSTLE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MED, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-23",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "1-10-7868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; 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.