Individual provider Active NPI

Susan Charlotte Kiningham

  • Behavior Technician
  • Shepherdsville, KY
National Provider Identifier
1750158523
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1707 Cedar Grove Rd
Shepherdsville, KY 40165-8572
Phone
(502) 633-1007
Fax
(502) 805-1511
NPI assigned
Dec 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

1707 Cedar Grove Rd
Shepherdsville, KY 40165-8572

Mailing address

90 Howard Dr
Shelbyville, KY 40065-8138
Phone (502) 633-1007

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

NPI Registry JSON

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1750158523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 HOWARD DR",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400658138",
            "telephone_number": "502-633-1007",
            "fax_number": "502-805-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 CEDAR GROVE RD",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401658572",
            "telephone_number": "502-633-1007",
            "fax_number": "502-805-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KININGHAM",
        "first_name": "SUSAN",
        "middle_name": "CHARLOTTE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shepherdsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.

Verify at the official NPI Registry.