Active NPI
Rosalind Marie Kendrick, MED
- Behavior Technician
- Poteau, OK
National Provider Identifier
1700117512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 22662 Hilltop Rd
Poteau, OK 74953-9058 - Phone
- (918) 658-8452
- NPI assigned
- Jan 18, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | NM | Primary |
Addresses
Primary practice location
22662 Hilltop Rd
Poteau, OK 74953-9058
Mailing address
PO Box 28414
Santa Fe, NM 87592-8414
Phone (918) 658-8452
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700117512 | Medicaid | NM |
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
- Credentials
- Master of Education
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483660800000",
"number": "1700117512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 28414",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875928414",
"telephone_number": "918-658-8452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22662 HILLTOP RD",
"city": "POTEAU",
"state": "OK",
"postal_code": "749539058",
"telephone_number": "918-658-8452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENDRICK",
"first_name": "ROSALIND",
"middle_name": "MARIE",
"credential": "MED",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-18",
"last_updated": "2017-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NM",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1700117512",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Poteau, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.