Active NPI
Ken O Booth
- Behavior Technician
- Kailua, HI
National Provider Identifier
1841975786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 203 Kapaa Quarry PL
#5002
Kailua, HI 96734 - Phone
- (808) 247-2973
- NPI assigned
- Jun 19, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Psychiatric Technician | 167G00000X | PT37597 | CA | |
| Behavior Technician | 106S00000X | HI | Primary |
Addresses
Primary practice location
203 Kapaa Quarry PL
#5002
Kailua, HI 96734
Mailing address
203 Kapaa Quarry PL
5002
Kailua, HI 96734
Phone (808) 247-2973
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT37597 | CA | MD | Licensed Psychiatric Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743033600000",
"number": "1841975786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "203 KAPAA QUARRY PL",
"address_2": "5002",
"city": "KAILUA",
"state": "HI",
"postal_code": "96734",
"telephone_number": "808-247-2973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 KAPAA QUARRY PL",
"address_2": "#5002",
"city": "KAILUA",
"state": "HI",
"postal_code": "96734",
"telephone_number": "808-247-2973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOOTH",
"first_name": "KEN",
"middle_name": "O",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-19",
"last_updated": "2025-03-27",
"certification_date": "2025-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "167G00000X",
"taxonomy_group": "",
"desc": "Licensed Psychiatric Technician",
"state": "CA",
"license": "PT37597",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "HI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kailua, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.