Khadijah Bygrave

Key facts

NPI

1780529883

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Technician 106S00000X

Practice address

360 Bloomfield Ave Ste 301
Windsor, CT 06095-2700

Phone

(860) 264-5500

NPI assigned

Apr 23, 2026

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 23, 2026.

{
    "created_epoch": "1776902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1780529883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 FAIRWAY DR STE 101",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334411834",
            "telephone_number": "866-500-2186",
            "fax_number": "877-418-2978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 BLOOMFIELD AVE STE 301",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952700",
            "telephone_number": "860-264-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYGRAVE",
        "first_name": "KHADIJAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-23",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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