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
- 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 and National Provider Directory roles.
-
- Behavior Analyst
- Bend, OR
- NPI 1942537444
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.