Individual provider Active NPI

Ryan-Taylor Keliikuli-Kennedy

  • Behavior Technician
  • Honolulu, HI
National Provider Identifier
1962139428
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
106S00000X Issued in HI
Practice address
1050 Lunalilo St Apt 1205
Honolulu, HI 96822-3974
Phone
(808) 779-3566
NPI assigned
Aug 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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 106S00000X HI Primary

Addresses

Primary practice location

1050 Lunalilo St Apt 1205
Honolulu, HI 96822-3974

Mailing address

1050 Lunalilo St Apt 1205
Honolulu, HI 96822-3974
Phone (808) 779-3566

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

LicenseStateTypeSpecialty
106S00000XHIMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
En Fleur Behavior Analysis, LLC PastSince Aug 7, 2022 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": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1962139428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 LUNALILO ST APT 1205",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968223974",
            "telephone_number": "808-779-3566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 LUNALILO ST APT 1205",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968223974",
            "telephone_number": "808-779-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELIIKULI-KENNEDY",
        "first_name": "RYAN-TAYLOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-04",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "HI",
            "license": "106S00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; 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.