Active NPI
Jaydon Douglas Stutz
- Behavior Technician
- Fairborn, OH
National Provider Identifier
1033609169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1750 Commerce Center Blvd
Fairborn, OH 45324-6333 - Phone
- (937) 878-8444
- NPI assigned
- May 15, 2018
- Sex
- Male
- 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 | Primary |
Addresses
Primary practice location
1750 Commerce Center Blvd
Fairborn, OH 45324-6333
Mailing address
222 N 2ND St
Tipp City, OH 45371-1910
Other practice location 1
222 N 2nd st
Tipp City, OH 45371
Phone (937) 479-1677
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": "1526342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526342400000",
"number": "1033609169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 N 2ND ST",
"city": "TIPP CITY",
"state": "OH",
"postal_code": "453711910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1750 COMMERCE CENTER BLVD",
"city": "FAIRBORN",
"state": "OH",
"postal_code": "453246333",
"telephone_number": "937-878-8444"
}
],
"practiceLocations": [
{
"address_1": "222 N 2nd st",
"address_purpose": "LOCATION",
"city": "Tipp City",
"state": "OH",
"postal_code": "45371",
"country_code": "US",
"telephone_number": "937-479-1677",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STUTZ",
"first_name": "JAYDON",
"middle_name": "DOUGLAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-15",
"last_updated": "2018-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairborn, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.