Khadijah Renee Smith

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

1848676 Issued in TX

Practice address

9449 Briar Forest Dr Apt 2705
Houston, TX 77063-1044

Phone

(662) 739-1988

NPI assigned

Feb 20, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519084800000",
    "number": "1669972253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9449 BRIAR FOREST DR APT 2705",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770631044",
            "telephone_number": "662-739-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9449 BRIAR FOREST DR APT 2705",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770631044",
            "telephone_number": "662-739-1988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KHADIJAH",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-20",
        "last_updated": "2018-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "TX",
            "license": "1848676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR TECHNICIAN",
            "identifier": "1848676",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Norris Smith, PA
• Kenneth Mondre Smith, PHYSICIAN ASSISTANT
• Kennyde Smith, DPT
• Kevin G Smith, PH.D.
• Kevin Patrick Smith, RN
• Kia Smith
• Kimberly C Smith, M.D.
• Kimberly Marie Smith
• Kishana Smith
• Kloey Smith

• Behavior Technician in Houston, TX
• Providers in Houston, TX by specialty
• Behavior Technician in Texas

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