Individual provider Active NPI

Kristopher Benson, RBT

  • Behavior Technician
  • Beavercreek, OH
National Provider Identifier
1417600628
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-22-201192 Issued in OH
Practice address
2522 Nutter Park Dr
Beavercreek, OH 45434-3500
Phone
(937) 306-8811
NPI assigned
Jan 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-22-201192
Behavior Technician 106S00000X RBT-22-201192 OH Primary

Addresses

Primary practice location

2522 Nutter Park Dr
Beavercreek, OH 45434-3500

Mailing address

1753 Arlin PL Apt H
Fairborn, OH 45324-2911
Phone (937) 516-0508

Other practice location 1

9260 Marketplace Dr
Miamisburg, OH 45342-4478
Phone (937) 388-5110

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-22-201192OHMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Solutions Behavior Group LLC CurrentSince Jul 17, 2022 Accepting new patients

Locations

2522 Nutter Park Dr
Dayton, OH 45434
Phone (859) 282-0400

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1643328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1417600628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1753 ARLIN PL APT H",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453242911",
            "telephone_number": "937-516-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2522 NUTTER PARK DR",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454343500",
            "telephone_number": "937-306-8811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9260 Marketplace Dr",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453424478",
            "country_code": "US",
            "telephone_number": "937-388-5110",
            "fax_number": "317-520-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENSON",
        "first_name": "KRISTOPHER",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-28",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": "RBT-22-201192",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "OH",
            "license": "RBT-22-201192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.