Active NPI
Kaden Threet
- Behavior Technician
- Rexburg, ID
National Provider Identifier
1649901646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 859 S Yellowstone Hwy Ste 202
Rexburg, ID 83440-5294 - Phone
- (307) 257-5487
- NPI assigned
- Jun 21, 2022
- 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
859 S Yellowstone Hwy Ste 202
Rexburg, ID 83440-5294
Mailing address
PO Box 20310 Unit 55984
Cheyenne, WY 82003-7007
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 |
|---|---|---|---|
| Jackson Hole Behavioral Services, LLC | Current | 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 and National Provider Directory roles.
-
- Early Intervention Provider Agency
- Laramie, WY
- NPI 1881071355
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697068800000",
"number": "1649901646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 20310 UNIT 55984",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820037007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "859 S YELLOWSTONE HWY STE 202",
"city": "REXBURG",
"state": "ID",
"postal_code": "834405294",
"telephone_number": "307-257-5487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THREET",
"first_name": "KADEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-21",
"last_updated": "2023-10-12",
"certification_date": "2023-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rexburg, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.