Individual provider Active NPI

Jaiden Holifield

  • Behavior Technician
  • Wichita, KS
National Provider Identifier
1396533303
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-24-402287 Issued in KS
Practice address
1109 S Rock Rd
Wichita, KS 67207-3317
Phone
(917) 801-7015
NPI assigned
Apr 29, 2025
Last updated
Jul 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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 RBT-24-402287 KS Primary

Addresses

Primary practice location

1109 S Rock Rd
Wichita, KS 67207-3317

Mailing address

16201 Wedd St
Overland Park, KS 66085-7857
Phone (913) 213-1418

Other practice location 1

2400 S Greenwich Rd
Wichita, KS 67210-1813
Phone (917) 801-7015

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

LicenseStateTypeSpecialty
RBT-24-402287KSMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Blooming Horizons, LLC CurrentSince May 4, 2025 Accepting new patients
R&R Collaborative Therapy Services PastSince Jan 1, 2022 Accepting new patients

Locations

1109 S Rock Rd
Wichita, KS 67207
Phone (917) 801-7015

2400 S Greenwich Rd
Wichita, KS 67210
Phone (917) 801-7015

825 Georges Rd
North Brunswick, NJ 08902
Phone (732) 828-8244

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": "1745884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1396533303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16201 WEDD ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "660857857",
            "telephone_number": "913-213-1418",
            "fax_number": "913-600-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 S ROCK RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672073317",
            "telephone_number": "917-801-7015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 S Greenwich Rd",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672101813",
            "country_code": "US",
            "telephone_number": "917-801-7015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLIFIELD",
        "first_name": "JAIDEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-29",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "KS",
            "license": "RBT-24-402287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; 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.