Active NPI
Kyle Bort
- Behavior Technician
- Chesterfield, MI
National Provider Identifier
1588149462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 53869 Connor Dr
Chesterfield, MI 48051-3930 - Phone
- (312) 965-2997
- NPI assigned
- Sep 26, 2018
- Last updated
- Nov 6, 2020
- Sex
- Male
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
53869 Connor Dr
Chesterfield, MI 48051-3930
Mailing address
2560 Sorority LN
Holt, MI 48842-9427
Phone (517) 488-3919
Other practice location 1
32100 Telegraph Rd Ste 205
Bingham Farms, MI 48025-2454
Phone (248) 712-4266
Other practice location 2
4000 W Michigan Ave
Lansing, MI 48917
Phone (517) 624-2395
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| ABA Pathways, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Behavior Analyst
- Ann Arbor, MI
- NPI 1770838468
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604620800000",
"number": "1588149462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2560 SORORITY LN",
"city": "HOLT",
"state": "MI",
"postal_code": "488429427",
"telephone_number": "517-488-3919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53869 CONNOR DR",
"city": "CHESTERFIELD",
"state": "MI",
"postal_code": "480513930",
"telephone_number": "312-965-2997"
}
],
"practiceLocations": [
{
"address_1": "32100 Telegraph Rd Ste 205",
"address_purpose": "LOCATION",
"city": "Bingham Farms",
"state": "MI",
"postal_code": "480252454",
"country_code": "US",
"telephone_number": "248-712-4266",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4000 W Michigan Ave",
"address_purpose": "LOCATION",
"city": "Lansing",
"state": "MI",
"postal_code": "48917",
"country_code": "US",
"telephone_number": "517-624-2395",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BORT",
"first_name": "KYLE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-26",
"last_updated": "2020-11-06",
"certification_date": "2020-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesterfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.