Individual provider Active NPI

Nan Huai, PH.D., BCBA-D

  • Psychologist
  • Madison, WI
National Provider Identifier
1841428935
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2769-57 Issued in WI
Practice address
1210 Fourier Drive
Suite #100
Madison, WI 53717-1969
Phone
(608) 662-9327
Fax
(608) 662-9041
NPI assigned
Jun 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2769-57 WI Primary
Behavior Analyst 103K00000X 60-140 WI

Addresses

Primary practice location

1210 Fourier Drive
Suite #100
Madison, WI 53717-1969

Mailing address

1210 Fourier Drive
Suite #100
Madison, WI 53717-1969
Phone (608) 662-9327

Other identifiers 2

IdentifierTypeStateIssuer
1841428935MedicaidWI
2469-57OtherWIPSYCHOLOGIST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jan 12, 2016 through Jan 12, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
60-140WIMDBehavioral Analyst
2769-57WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Autism Spectrum Therapies of Delaware, LLC Behavior Analyst Past Accepting new patients

Organizations & group practices 1

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": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1841428935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 FOURIER DRIVE",
            "address_2": "SUITE #100",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171969",
            "telephone_number": "608-662-9327",
            "fax_number": "608-662-9041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 FOURIER DRIVE",
            "address_2": "SUITE #100",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171969",
            "telephone_number": "608-662-9327",
            "fax_number": "608-662-9041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUAI",
        "first_name": "NAN",
        "credential": "PH.D., BCBA-D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-26",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2769-57",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WI",
            "license": "60-140",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841428935",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST",
            "identifier": "2469-57",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.