Individual provider Active NPI

Kera Kidd

  • Behavior Analyst
  • Fulshear, TX
National Provider Identifier
1477067809
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
2006 Issued in TX
Practice address
31527 Eldorado LN
Fulshear, TX 77441-2256
Phone
(832) 786-9638
NPI assigned
Nov 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-17-28930 TX
Behavior Technician 106S00000X
Behavior Analyst 103K00000X 2006 TX Primary

Addresses

Primary practice location

31527 Eldorado LN
Fulshear, TX 77441-2256

Mailing address

31527 Eldorado LN
Fulshear, TX 77441-2256

Other practice location 1

100 Congress Ave Ste 2000
Austin, TX 78701-2745
Phone (888) 880-9270

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
2006TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Kidd'S Kids ABA Therapy Behavior Analyst Current Accepting new patients
Kidd ABA Behavior Analyst CurrentSince Oct 6, 2024 Accepting new patients

Locations

22720 Morton Ranch Rd
Ste 160
Katy, TX 77449
Phone (409) 292-7685

Organizations & group practices 2

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": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1477067809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31527 ELDORADO LN",
            "city": "FULSHEAR",
            "state": "TX",
            "postal_code": "774412256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31527 ELDORADO LN",
            "city": "FULSHEAR",
            "state": "TX",
            "postal_code": "774412256",
            "telephone_number": "832-786-9638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Congress Ave Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787012745",
            "country_code": "US",
            "telephone_number": "888-880-9270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIDD",
        "first_name": "KERA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-21",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-17-28930",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "2006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulshear, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.