Individual provider Active NPI

Jayla McKenzie Bullock

  • Behavior Technician
  • Smithfield, NC
National Provider Identifier
1063318392
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-26-538292
Practice address
300 S 3Rd St
Smithfield, NC 27577-4575
Phone
(574) 387-4313
NPI assigned
Oct 14, 2026
Last updated
Oct 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-26-538292 Primary

Addresses

Primary practice location

300 S 3Rd St
Smithfield, NC 27577-4575

Mailing address

300 S 3Rd St
Smithfield, NC 27577-4575
Phone (574) 387-4313

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": "1791936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791936000000",
    "number": "1063318392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S 3RD ST",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275774575",
            "telephone_number": "574-387-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S 3RD ST",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275774575",
            "telephone_number": "574-387-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "JAYLA",
        "middle_name": "MCKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-14",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": "RBT-26-538292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithfield, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2026; 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.