Individual provider Active NPI

Dajsha Avery

  • Behavior Technician
  • Allendale, MI
National Provider Identifier
1366978371
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
11355 Kistler Dr
Allendale, MI 49401-9433
Phone
(937) 232-4313
NPI assigned
May 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 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 Primary

Addresses

Primary practice location

11355 Kistler Dr
Allendale, MI 49401-9433

Mailing address

11355 Kistler Dr
Allendale, MI 49401-9433

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1366978371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11355 KISTLER DR",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494019433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11355 KISTLER DR",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494019433",
            "telephone_number": "937-232-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERY",
        "first_name": "DAJSHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allendale, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.