Individual provider Active NPI

Michael Kieran, MS BCBA

  • Behavior Analyst
  • Chico, CA
National Provider Identifier
1376196543
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-19-36407 Issued in CA
Practice address
55 Declaration Dr Ste B
Chico, CA 95973-4965
Phone
(530) 487-7265
Fax
(530) 487-7263
NPI assigned
Jul 17, 2019
Last updated
Jul 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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 1-19-36407 CA Primary

Addresses

Primary practice location

55 Declaration Dr Ste B
Chico, CA 95973-4965

Mailing address

55 Declaration Dr Ste B
Chico, CA 95973-4965
Phone (530) 487-7265

Other names 1

  • Michael M Kieran 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
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Family Behavior Solutions Behavior Analyst CurrentSince Aug 18, 2019 Accepting new patients
Nexus Therapies LLC Past Accepting new patients

Locations

55 Declaration Dr
Ste B
Chico, CA 95973
Phone (530) 487-7265

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1376196543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 DECLARATION DR STE B",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959734965",
            "telephone_number": "530-487-7265",
            "fax_number": "530-487-7263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 DECLARATION DR STE B",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959734965",
            "telephone_number": "530-487-7265",
            "fax_number": "530-487-7263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIERAN",
        "first_name": "MICHAEL",
        "credential": "MS BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-19-36407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "KIERAN",
            "middle_name": "M",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chico, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.