Jackson Bailey

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

35 Skyline Dr
Brigham City, UT 84302-6772

Phone

(801) 255-5131

NPI assigned

Nov 8, 2022

Last updated

Nov 8, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ryse ABA Therapy LLC

  • Behavior Analyst
  • Washington, UT
  • NPI 1386516037
  NPD

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1013625110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6013 S REDWOOD RD",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841235220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 SKYLINE DR",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843026772",
            "telephone_number": "801-255-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "JACKSON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR TECH",
            "identifier": "1104119619",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@utbs.co",
            "affiliation": "N",
            "address_1": "35 Skyline Dr",
            "city": "Brigham City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "843026772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Douglas Bryan Atkinson
• Seth Ezekiel Atwater, AMFT
• Ethan Audette
• Avalon Care Center - Brigham City, L.L.C. (Pioneer Care Center)
• Annie Averett
• Jillian Bailey
• Stanton A Bailey, M.D.
• Warren Dewitt Bailey
• Emilly Bair
• Lauri Baird

• Behavior Technician in Brigham City, UT
• Providers in Brigham City, UT by specialty
• Behavior Technician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.