NPIMap

Individual provider Active NPI

Jessica Ellen Graul, BCBA

  • Behavior Analyst
  • Cary, NC
National Provider Identifier
1114452794
Registry record updated May 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-17-25813 Issued in NC
Practice address
111 Mackenan Dr
Cary, NC 27511
Phone
(484) 347-6250
NPI assigned
Apr 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-17-25813 NC Primary

Addresses

Primary practice location

111 Mackenan Dr
Cary, NC 27511

Mailing address

111 Mackenan Dr
Cary, NC 27511-7903
Phone (484) 347-6250

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Carolina Center for ABA & Autism Treatment Past Accepting new patients
Carolina Center for Autism Services, LLC Behavior Analyst Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527379200000",
    "number": "1114452794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MACKENAN DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275117903",
            "telephone_number": "484-347-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MACKENAN DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27511",
            "telephone_number": "484-347-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAUL",
        "first_name": "JESSICA",
        "middle_name": "ELLEN",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-20",
        "last_updated": "2018-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "1-17-25813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

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