Individual provider Active NPI

Diamond Nelson, RBT

  • Behavior Analyst
  • Lawrenceville, GA
National Provider Identifier
1124717723
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
23-263646 Issued in GA
Practice address
2387 Huntcrest Way
Lawrenceville, GA 30043-8126
Phone
(678) 648-7644
NPI assigned
May 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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 23-263646 GA Primary

Addresses

Primary practice location

2387 Huntcrest Way
Lawrenceville, GA 30043-8126

Mailing address

6505 Shiloh Rd Ste 100
Alpharetta, GA 30005-1645
Phone (678) 648-7644

Other practice location 1

1415 Oak Knoll Dr NE
Conyers, GA 30012-4751
Phone (762) 282-4173

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

State licenses

LicenseStateTypeSpecialty
23-263646GAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1124717723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6505 SHILOH RD STE 100",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300051645",
            "telephone_number": "678-648-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2387 HUNTCREST WAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300438126",
            "telephone_number": "678-648-7644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 Oak Knoll Dr NE",
            "address_purpose": "LOCATION",
            "city": "Conyers",
            "state": "GA",
            "postal_code": "300124751",
            "country_code": "US",
            "telephone_number": "762-282-4173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "DIAMOND",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-01",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "23-263646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; 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.