Individual provider Active NPI

Kwaun Nicole Dukes-Reese, RBT

  • Behavior Technician
  • Ann Arbor, MI
National Provider Identifier
1558830505
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
820799715 Issued in MI
Practice address
100 N Staebler Rd
Ann Arbor, MI 48103-9755
Phone
(734) 252-6522
NPI assigned
Nov 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106S00000X 820799715 MI Primary

Addresses

Primary practice location

100 N Staebler Rd
Ann Arbor, MI 48103-9755

Mailing address

100 N Staebler Rd
Ann Arbor, MI 48103-9755
Phone (734) 252-6522

Other practice location 1

1048 Pierpont Dr Ste 9
Lansing, MI 48911-5976
Phone (734) 252-6522

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
820799715MIMDBehavior Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1558830505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N STAEBLER RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039755",
            "telephone_number": "734-252-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N STAEBLER RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039755",
            "telephone_number": "734-252-6522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1048 Pierpont Dr Ste 9",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489115976",
            "country_code": "US",
            "telephone_number": "734-252-6522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUKES-REESE",
        "first_name": "KWAUN",
        "middle_name": "NICOLE",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-20",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": "MI",
            "license": "820799715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; 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.