Active NPI
Kenadid Hiss
- Behavior Technician
- Minneapolis, MN
National Provider Identifier
1437897204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 4001 Stinson Blvd NE Ste 314
Minneapolis, MN 55421-3424 - Phone
- (612) 298-7636
- Fax
- (612) 354-3801
- NPI assigned
- May 23, 2022
- Sex
- Male
- 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 | MI | Primary |
Addresses
Primary practice location
4001 Stinson Blvd NE Ste 314
Minneapolis, MN 55421-3424
Mailing address
140 W 31St St
Minneapolis, MN 55408-3105
Phone (612) 426-8484
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": "1653264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653264000000",
"number": "1437897204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 W 31ST ST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554083105",
"telephone_number": "612-426-8484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4001 STINSON BLVD NE STE 314",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554213424",
"telephone_number": "612-298-7636",
"fax_number": "612-354-3801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HISS",
"first_name": "KENADID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-23",
"last_updated": "2022-05-23",
"certification_date": "2022-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MI",
"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 May 23, 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.