Active NPI
Celena Kerns
- Behavior Technician
- Wasilla, AK
National Provider Identifier
1386342756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-258345
- Practice address
- 1175 N Leatherleaf Loop Ste C
Wasilla, AK 99654-6527 - Phone
- (907) 212-1674
- NPI assigned
- Feb 15, 2023
- 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 | RBT-23-258345 | AK | Primary |
Addresses
Primary practice location
1175 N Leatherleaf Loop Ste C
Wasilla, AK 99654-6527
Mailing address
1175 N Leatherleaf Loop Ste C
Wasilla, AK 99654-6527
Phone (907) 212-1674
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 216291 | Medicaid | AK |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-23-258345 | AK | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676419200000",
"number": "1386342756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1175 N LEATHERLEAF LOOP STE C",
"city": "WASILLA",
"state": "AK",
"postal_code": "996546527",
"telephone_number": "907-212-1674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 N LEATHERLEAF LOOP STE C",
"city": "WASILLA",
"state": "AK",
"postal_code": "996546527",
"telephone_number": "907-212-1674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERNS",
"first_name": "CELENA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-15",
"last_updated": "2023-02-15",
"certification_date": "2023-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "AK",
"license": "RBT-23-258345",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "216291",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.