Jill Renae Emmick, M.A. BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

2323 E Paris Ave SE Ste 101
Grand Rapids, MI 49546-2414

Phone

(616) 610-5697

NPI assigned

Jan 27, 2011

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

• Jill Meiste Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1296086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296086400000",
    "number": "1114223997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 E PARIS AVE SE STE 101",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 E PARIS AVE SE STE 101",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462414",
            "telephone_number": "616-610-5697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMMICK",
        "first_name": "JILL",
        "middle_name": "RENAE",
        "credential": "M.A. BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-27",
        "last_updated": "2011-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "MEISTE",
            "credential": "M.A. BCBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emmanuel Hospice
• Emmanuel Hospice
• David Emmenecker
• Erin Eileen Emmert
• Stacy Michelle Emmert, PA-C
• Misty Emmons, NP
• James E Emms, D.C.
• Empower Counseling Services, LLC
• Empowered Inner Peace LLC
• Empowering Therapy Mi, PLLC

• All providers in Grand Rapids, MI
• Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; 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.