Active NPI
Raheem Michael Brown
- Behavior Technician
- Novi, MI
National Provider Identifier
1528592888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- B 650730603670
- Practice address
- 41521 W 11 Mile Rd
Novi, MI 48375-1803 - Phone
- (616) 482-9017
- NPI assigned
- Apr 13, 2017
- Sex
- Male
- 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 | B 650730603670 | MI | Primary |
Addresses
Primary practice location
41521 W 11 Mile Rd
Novi, MI 48375-1803
Mailing address
41521 W 11 Mile Rd
Novi, MI 48375-1803
Phone (616) 482-9017
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 947116505-00 | Other | MI | PRIORITY HEALTH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| B 650730603670 | MI | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492041600000",
"number": "1528592888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41521 W 11 MILE RD",
"city": "NOVI",
"state": "MI",
"postal_code": "483751803",
"telephone_number": "616-482-9017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41521 W 11 MILE RD",
"city": "NOVI",
"state": "MI",
"postal_code": "483751803",
"telephone_number": "616-482-9017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "RAHEEM",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-04-13",
"last_updated": "2017-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MI",
"license": "B 650730603670",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIORITY HEALTH",
"identifier": "947116505-00",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Novi, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.