Active NPI
Kassie L McKnight
- Behavior Technician
- River Rouge, MI
National Provider Identifier
1467196931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 106S00000X
- Practice address
- 499 Frazier St
River Rouge, MI 48218 - Phone
- (313) 459-9219
- NPI assigned
- Apr 21, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | 106S00000X | Primary |
Addresses
Primary practice location
499 Frazier St
River Rouge, MI 48218
Mailing address
499 Frazier St
River Rouge, MI 48218
Phone (313) 459-9219
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0055475256 | Other | MI | MEDICAID |
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": "1650499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651622400000",
"number": "1467196931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "499 FRAZIER ST",
"city": "RIVER ROUGE",
"state": "MI",
"postal_code": "48218",
"telephone_number": "313-459-9219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "499 FRAZIER ST",
"city": "RIVER ROUGE",
"state": "MI",
"postal_code": "48218",
"telephone_number": "313-459-9219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKNIGHT",
"first_name": "KASSIE",
"middle_name": "L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-21",
"last_updated": "2022-05-04",
"certification_date": "2022-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": "106S00000X",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "0055475256",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in River Rouge, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.