Individual provider Active NPI

Tijah Terry

  • Behavior Technician
  • Jeffersonville, IN
National Provider Identifier
1104790419
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
355 Quartermaster CT
Jeffersonville, IN 47130-3670
Phone
(812) 258-9802
NPI assigned
Sep 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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 Primary

Addresses

Primary practice location

355 Quartermaster CT
Jeffersonville, IN 47130-3670

Mailing address

3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135

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": "1759190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1104790419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BLVD STE 3070",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 QUARTERMASTER CT",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303670",
            "telephone_number": "812-258-9802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "TIJAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-30",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; 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.