Active NPI
Kristin M Randy, BCBA,LBA
- Behavior Analyst
- Fishers, IN
National Provider Identifier
1669830360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-19-34941
- Practice address
- 12625 Walrond Rd
Fishers, IN 46037-6632 - Phone
- (541) 241-6446
- NPI assigned
- Feb 9, 2016
- Last updated
- Nov 3, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | ABA-IN-10174842 | OR | |
| Behavior Analyst | 103K00000X | 1-19-34941 | IN | Primary |
Addresses
Primary practice location
12625 Walrond Rd
Fishers, IN 46037-6632
Mailing address
12625 Walrond Rd
Fishers, IN 46037-6632
Phone (541) 241-6446
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 |
|---|---|---|---|
| ABA-IN-10174842 | OR | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cascade Behavioral Intervention, LLC | Behavior Analyst | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635897600000",
"number": "1669830360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12625 WALROND RD",
"city": "FISHERS",
"state": "IN",
"postal_code": "460376632",
"telephone_number": "541-241-6446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12625 WALROND RD",
"city": "FISHERS",
"state": "IN",
"postal_code": "460376632",
"telephone_number": "541-241-6446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDY",
"first_name": "KRISTIN",
"middle_name": "M",
"credential": "BCBA,LBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-09",
"last_updated": "2021-11-03",
"certification_date": "2021-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "OR",
"license": "ABA-IN-10174842",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IN",
"license": "1-19-34941",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fishers, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.