Active NPI
Jamie Johnson, BCBA
- Behavior Analyst
- Las Vegas, NV
National Provider Identifier
1033564588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- LABA0006
- Practice address
- 630 S Rancho Dr
Ste a
Las Vegas, NV 89106-4873 - Phone
- (702) 564-2453
- Fax
- (702) 527-5353
- NPI assigned
- May 3, 2016
- Last updated
- Feb 26, 2018
- 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 Analyst | 103K00000X | LABA0006 | NV | Primary |
Addresses
Primary practice location
630 S Rancho Dr
Ste a
Las Vegas, NV 89106-4873
Mailing address
8405 Sea Glen Dr
Las Vegas, NV 89128-7180
Phone (702) 812-9381
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-16-21516 | Other | NV | BOARD CERTIFIED BEHAVIOR ANALYST |
| 1033564588 | Medicaid | NV |
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 |
|---|---|---|---|
| LABA0006 | NV | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519603200000",
"number": "1033564588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8405 SEA GLEN DR",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891287180",
"telephone_number": "702-812-9381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 S RANCHO DR",
"address_2": "STE A",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891064873",
"telephone_number": "702-564-2453",
"fax_number": "702-527-5353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JAMIE",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-03",
"last_updated": "2018-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NV",
"license": "LABA0006",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD CERTIFIED BEHAVIOR ANALYST",
"identifier": "1-16-21516",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1033564588",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.