Jennifer Pannebaker

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-14-9812 Issued in FL

Practice address

813 Randall Ave
Cheyenne, WY 82001

Phone

(719) 469-4906

NPI assigned

Dec 16, 2016

Last updated

Jan 6, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Bauserman Former name

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ohana ABA Consulting, LLC

  • Behavior Analyst
  • Cheyenne, WY
  • NPI 1598372468
  NPD Authorized official
• Stride Learning Center

  • Clinic/Center
  • Cheyenne, WY
  • NPI 1811030554
  NPD (past)

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

{
    "created_epoch": "1481846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1104360726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 RANDALL AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820012559",
            "telephone_number": "719-469-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 RANDALL AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "82001",
            "telephone_number": "719-469-4906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3217 S Macdill Ave",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336291719",
            "country_code": "US",
            "telephone_number": "813-284-7941",
            "fax_number": "813-284-7942",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "326 Parsley Blvd",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820071014",
            "country_code": "US",
            "telephone_number": "307-632-2991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANNEBAKER",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-16",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-14-9812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BAUSERMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pain Treatment Center of Wyoming, LLC
• Jolene Marie Paiz
• Hannah Brooke Palmer
• Mary Elizabeth Palmquist, PHARMD
• Morgan Palser
• Shalla Pannell, RN
• Kiera Lee Papish, MS, RD, LD
• Paramount Revenue LLC
• Cynthia Park
• Daizy Joann Parker

• Behavior Analyst in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Behavior Analyst in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; 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.