Kailey Addis

Key facts

NPI

1972252245

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Technician 106S00000X

Practice address

1401 E 7TH St
Charlotte, NC 28204-6300

Phone

(704) 780-4271

NPI assigned

Mar 22, 2022

Sex

Female

Sole proprietor

Yes

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 Mar 22, 2022.

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1972252245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 E 7TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282046300",
            "telephone_number": "704-780-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 E 7TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282046300",
            "telephone_number": "704-780-4271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDIS",
        "first_name": "KAILEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Charlotte, NC · Behavior Technician in North Carolina