Individual provider Active NPI

Kendall Darnell Miller

  • Behavior Technician
  • Alpena, MI
National Provider Identifier
1760033609
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
400 Johnson St
Alpena, MI 49707-1434
Phone
(989) 358-2161
NPI assigned
Sep 23, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

400 Johnson St
Alpena, MI 49707-1434

Mailing address

400 Johnson St
Alpena, MI 49707-1434

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Michigan Community Mental Health Authority CurrentSince Sep 29, 2019 Accepting new patients
Northeast Michigan Community Mental Health Authority PastSince Sep 29, 2019 Accepting new patients

Locations

400 Johnson St
Alpena, MI 49707
Phone (989) 354-2515

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1760033609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 JOHNSON ST",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 JOHNSON ST",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071434",
            "telephone_number": "989-358-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KENDALL",
        "middle_name": "DARNELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-23",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpena, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.