Active NPI
Jacqueline Marie Woodyard
- Behavior Technician
- Centennial, CO
National Provider Identifier
1063128593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 12503 E Euclid Dr Ste 55
Centennial, CO 80111-6466 - Phone
- (888) 754-0398
- NPI assigned
- Jan 27, 2023
- Sex
- Female
- Sole proprietor
- Yes
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
12503 E Euclid Dr Ste 55
Centennial, CO 80111-6466
Mailing address
4982 S Ulster St Apt 604
Denver, CO 80237-2822
Phone (513) 252-6603
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10S00000X | Other | N/A |
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": "1674777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674777600000",
"number": "1063128593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4982 S ULSTER ST APT 604",
"city": "DENVER",
"state": "CO",
"postal_code": "802372822",
"telephone_number": "513-252-6603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12503 E EUCLID DR STE 55",
"city": "CENTENNIAL",
"state": "CO",
"postal_code": "801116466",
"telephone_number": "888-754-0398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODYARD",
"first_name": "JACQUELINE",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-27",
"last_updated": "2023-01-27",
"certification_date": "2023-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "N/A",
"identifier": "10S00000X",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Centennial, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.