Benjamin Ryan Jack, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-17-28975 Issued in RI

Practice address

1130 Ten Rod Rd Ste 201
North Kingstown, RI 02852-4161

Phone

(401) 294-3990

NPI assigned

Jan 16, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Perspectives Corporation

  • Behavior Analyst
  • North Kingstown, RI
  • NPI 1689940371
  NPD (past)

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

{
    "created_epoch": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516060800000",
    "number": "1093223703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 TEN ROD RD STE C201",
            "address_2": "BUILDING C SUITE 201",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028524171",
            "telephone_number": "401-294-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 TEN ROD RD STE 201",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028524161",
            "telephone_number": "401-294-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACK",
        "first_name": "BENJAMIN",
        "middle_name": "RYAN",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-16",
        "last_updated": "2018-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "RI",
            "license": "1-17-28975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christian Humulock, OD
• Patricia J Hussey, LMHC
• Jacqueline Faith Ingham
• Ink Well Neuropsychology, LLC
• J. D. Gloor, M. D., Inc.
• Misty Jackson
• Teresa Jacob, D.D.S.
• Jessies Whole-Istic Care
• John Verbeyst, DMD
• Nancy E Johnson-Gallagher, LICSW

• Behavior Analyst in North Kingstown, RI
• Providers in North Kingstown, RI by specialty
• Behavior Analyst in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.

Verify at the official NPI Registry.