Active NPI
Hailly Renee Keith
- Behavior Technician
- Durant, OK
National Provider Identifier
1952941775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- Y8818514
- Practice address
- 529 S 7TH Ave
Durant, OK 74701-6621 - Phone
- (580) 579-2577
- NPI assigned
- Jan 9, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Y8818514 | CA | Primary |
Addresses
Primary practice location
529 S 7TH Ave
Durant, OK 74701-6621
Mailing address
529 S 7TH Ave
Durant, OK 74701-6621
Phone (580) 579-2577
Other practice location 1
529 S 7th Ave
Durant, OK 74701-6621
Phone (580) 579-2577
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 |
|---|---|---|---|
| Y8818514 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578528000000",
"number": "1952941775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "529 S 7TH AVE",
"city": "DURANT",
"state": "OK",
"postal_code": "747016621",
"telephone_number": "580-579-2577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "529 S 7TH AVE",
"city": "DURANT",
"state": "OK",
"postal_code": "747016621",
"telephone_number": "580-579-2577"
}
],
"practiceLocations": [
{
"address_1": "529 S 7th Ave",
"address_purpose": "LOCATION",
"city": "Durant",
"state": "OK",
"postal_code": "747016621",
"country_code": "US",
"telephone_number": "580-579-2577",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KEITH",
"first_name": "HAILLY",
"middle_name": "RENEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-09",
"last_updated": "2020-01-09",
"certification_date": "2020-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": "CA",
"license": "Y8818514",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durant, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.