Individual provider Active NPI

Jordyn Lewis

  • Behavior Technician
  • Lawrenceville, GA
National Provider Identifier
1083317028
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-23-264832 Issued in GA
Practice address
1631 Flinthaven CT
Lawrenceville, GA 30043-4951
Phone
(770) 508-4192
NPI assigned
Mar 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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-23-264832 GA Primary

Addresses

Primary practice location

1631 Flinthaven CT
Lawrenceville, GA 30043-4951

Mailing address

1631 Flinthaven CT
Lawrenceville, GA 30043-4951
Phone (770) 508-4192

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://login.centralreach.com Direct

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

LicenseStateTypeSpecialty
RBT-23-264832GAMDBehavior Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1083317028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 FLINTHAVEN CT",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434951",
            "telephone_number": "770-508-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 FLINTHAVEN CT",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434951",
            "telephone_number": "770-508-4192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JORDYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "RBT-23-264832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://login.centralreach.com",
            "affiliation": "N",
            "endpointDescription": "This is where employees will have access to your clients, communicate with your colleagues, and view their timesheets.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Identifies the content that is supported by the endpoint",
            "address_1": "1631 Flinthaven Ct",
            "city": "Lawrenceville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300434951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

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

Verify at the official NPI Registry.