Active NPI
Jessica Nicole Nisby, RBT
- Behavior Technician
- Chipley, FL
National Provider Identifier
1124757380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB777174
- Practice address
- 1691 Main St Ste 2
Chipley, FL 32428-6959 - Phone
- (334) 579-6030
- NPI assigned
- Jun 5, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | BACB777174 | AL | Primary |
Addresses
Primary practice location
1691 Main St Ste 2
Chipley, FL 32428-6959
Mailing address
686 Nobles Rd Lot 8
Cottonwood, AL 36320-3400
Phone (334) 579-6030
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
| License | State | Type | Specialty |
|---|---|---|---|
| BACB777174 | AL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654387200000",
"number": "1124757380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "686 NOBLES RD LOT 8",
"city": "COTTONWOOD",
"state": "AL",
"postal_code": "363203400",
"telephone_number": "334-579-6030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1691 MAIN ST STE 2",
"city": "CHIPLEY",
"state": "FL",
"postal_code": "324286959",
"telephone_number": "334-579-6030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NISBY",
"first_name": "JESSICA",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "RBT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-05",
"last_updated": "2022-06-05",
"certification_date": "2022-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "AL",
"license": "BACB777174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chipley, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.