Individual provider Active NPI

Doreen P. Poehling

  • Behavior Technician
  • Minneapolis, MN
National Provider Identifier
1407494099
Registry record updated Dec 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
2925 Dean Pkwy
Minneapolis, MN 55416-4470
Phone
(612) 925-8365
NPI assigned
Dec 15, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2019

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

2925 Dean Pkwy
Minneapolis, MN 55416-4470

Mailing address

9210 S 74TH St
Lincoln, NE 68516-4323
Phone (402) 314-4806

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": "1576368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576368000000",
    "number": "1407494099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9210 S 74TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685164323",
            "telephone_number": "402-314-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 DEAN PKWY",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164470",
            "telephone_number": "612-925-8365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POEHLING",
        "first_name": "DOREEN",
        "middle_name": "P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-15",
        "last_updated": "2019-12-15",
        "certification_date": "2019-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.