Individual provider Active NPI

Keshauna Wilson

  • Behavior Analyst
  • Farmington Hills, MI
National Provider Identifier
1346790045
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5326
Phone
(248) 299-0030
Fax
(248) 621-3830
NPI assigned
Oct 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5326

Mailing address

27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5326
Phone (586) 222-1361

Other names 1

  • Keshauna Hawkins Former 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

NPI Registry JSON

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1346790045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27777 INKSTER RD STE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483345326",
            "telephone_number": "586-222-1361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27777 INKSTER RD STE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483345326",
            "telephone_number": "248-299-0030",
            "fax_number": "248-621-3830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KESHAUNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-06",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KESHAUNA",
            "last_name": "HAWKINS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; 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.