Individual provider Active NPI

Kyle Dranchak, BCBA

  • Behavior Analyst
  • Champaign, IL
National Provider Identifier
1457957292
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
2301 W Bradley Ave
Champaign, IL 61821-1849
Phone
(317) 802-7447
Fax
(317) 802-7325
NPI assigned
Dec 8, 2020
Last updated
Oct 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary
Behavior Technician 106S00000X NU

Addresses

Primary practice location

2301 W Bradley Ave
Champaign, IL 61821-1849

Mailing address

1827 E Ireland Rd
South Bend, IN 46614-2845
Phone (574) 387-4313

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vav Operations Il, LLC Behavior Analyst CurrentSince Oct 30, 2022 Accepting new patients
Vav Operations LLC Behavior Analyst CurrentSince Oct 30, 2022 Accepting new patients
Access Behavioral Health Solutions Behavior Analyst PastSince Dec 1, 2020 Accepting new patients

Locations

2301 W Bradley Ave
Champaign, IL 61821
Phone (248) 919-8627

1827 E Ireland Rd
South Bend, IN 46614
Phone (574) 387-4309

Organizations & group practices 3

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": "1607385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1457957292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1827 E IRELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142845",
            "telephone_number": "574-387-4313",
            "fax_number": "574-204-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 W BRADLEY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618211849",
            "telephone_number": "317-802-7447",
            "fax_number": "317-802-7325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRANCHAK",
        "first_name": "KYLE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-08",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.