Individual provider Active NPI

Jasmelle Jaramillo-Mora

  • Assistant Behavior Analyst
  • Spring Lake, NC
National Provider Identifier
1023550464
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
02111848 Issued in NC
Practice address
1018 N Bragg Blvd
Spring Lake, NC 28390-3316
Phone
(910) 295-2609
NPI assigned
Nov 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT1745161 FL
Behavior Technician 106S00000X RBT1745161 NC
Assistant Behavior Analyst 106E00000X 02111848 NC Primary

Addresses

Primary practice location

1018 N Bragg Blvd
Spring Lake, NC 28390-3316

Mailing address

1580 Haileys Ferry Rd
Lilesville, NC 28091-7099
Phone (786) 393-3941

Other practice location 1

14335 SW 120th St
Suite 201
Miami, FL 33186-7294
Phone (305) 967-8074

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
02111848NCMDAssistant Behavior Analyst
RBT1745161FLMDBehavior Technician
RBT1745161NCMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Ana Ansin, Inc Past 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": "1479254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1023550464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 HAILEYS FERRY RD",
            "city": "LILESVILLE",
            "state": "NC",
            "postal_code": "280917099",
            "telephone_number": "786-393-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 N BRAGG BLVD",
            "city": "SPRING LAKE",
            "state": "NC",
            "postal_code": "283903316",
            "telephone_number": "910-295-2609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14335 SW 120th St",
            "address_2": "SUITE 201",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331867294",
            "country_code": "US",
            "telephone_number": "305-967-8074",
            "fax_number": "305-967-8302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JARAMILLO-MORA",
        "first_name": "JASMELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-16",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT1745161",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NC",
            "license": "RBT1745161",
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "NC",
            "license": "02111848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Lake, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.

Verify at the official NPI Registry.