Active NPI
Jeremiah Harden
- Behavior Technician
- Newport News, VA
National Provider Identifier
1043035199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 24-373229
- Practice address
- 825 Diligence Dr Ste 102
Newport News, VA 23606-4211 - Phone
- (254) 249-6530
- Fax
- (903) 200-1505
- NPI assigned
- Nov 22, 2024
- 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 | 24-373229 | VA | Primary |
Addresses
Primary practice location
825 Diligence Dr Ste 102
Newport News, VA 23606-4211
Mailing address
109 E Lakeshore Dr Apt 416
Hampton, VA 23666-2379
Phone (757) 738-9163
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 |
|---|---|---|---|
| 24-373229 | VA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texoma ABA, LLC | Behavior Technician | 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": "1732233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732233600000",
"number": "1043035199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 E LAKESHORE DR APT 416",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236662379",
"telephone_number": "757-738-9163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 DILIGENCE DR STE 102",
"city": "NEWPORT NEWS",
"state": "VA",
"postal_code": "236064211",
"telephone_number": "254-249-6530",
"fax_number": "903-200-1505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARDEN",
"first_name": "JEREMIAH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-11-22",
"last_updated": "2024-11-22",
"certification_date": "2024-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "VA",
"license": "24-373229",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport News, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.