Active NPI
Ruby Simone Schickel Prather
- Behavior Technician
- Boulder, CO
National Provider Identifier
1992384481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 670800
- Practice address
- 4770 Baseline Rd
Boulder, CO 80303-2666 - Phone
- (970) 682-3476
- NPI assigned
- Apr 3, 2021
- Sex
- Female
- Sole proprietor
- No
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 | 670800 | CO | Primary |
Addresses
Primary practice location
4770 Baseline Rd
Boulder, CO 80303-2666
Mailing address
18726 S Western Ave
Gardena, CA 90248-3813
Phone (310) 856-0800
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 |
|---|---|---|---|
| 670800 | CO | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617408000000",
"number": "1992384481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18726 S WESTERN AVE",
"city": "GARDENA",
"state": "CA",
"postal_code": "902483813",
"telephone_number": "310-856-0800",
"fax_number": "855-568-2494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4770 BASELINE RD",
"city": "BOULDER",
"state": "CO",
"postal_code": "803032666",
"telephone_number": "970-682-3476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRATHER",
"first_name": "RUBY",
"middle_name": "SIMONE SCHICKEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-03",
"last_updated": "2021-04-03",
"certification_date": "2021-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CO",
"license": "670800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boulder, CO
- Moira Powers, PH.D.
- Sharon Irene Powers, R.N.
- Victoria Powers, PHARMACIST
- Annemarie Curran Prairie, MA, LPC, CAC III
- Courtney Catherine Pramann, ANP-C
- Precision Medication Center of Colorado
- Catherine Louise Precourt
- Premise Health of Colorado Medical PC
- Dhunyanun Premwhaew, DACCHM, L.AC., OLY
- Michael C Prescher, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.