Individual provider Active NPI

Khadar Liban Haji

  • Behavior Technician
  • Rosemount, MN
National Provider Identifier
1972485241
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
15039 Athgoe Dr
Rosemount, MN 55068-6584
Phone
(651) 418-7275
NPI assigned
Jul 25, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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 Primary

Addresses

Primary practice location

15039 Athgoe Dr
Rosemount, MN 55068-6584

Mailing address

15039 Athgoe Dr
Rosemount, MN 55068-6584

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1753401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1972485241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15039 ATHGOE DR",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550686584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15039 ATHGOE DR",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550686584",
            "telephone_number": "651-418-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAJI",
        "first_name": "KHADAR",
        "middle_name": "LIBAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-25",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosemount, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.

Verify at the official NPI Registry.