Active NPI
Jaymi Nelson, BCBA
- Behavior Analyst
- Shakopee, MN
National Provider Identifier
1134739279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-24-71109
- Practice address
- 1308 Greenwood CT
Shakopee, MN 55379-4452 - Phone
- (161) 235-5652
- NPI assigned
- Aug 4, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-24-71109 | MN | Primary |
| Behavior Technician | 106S00000X | RBT-20-146620 | MN |
Addresses
Primary practice location
1308 Greenwood CT
Shakopee, MN 55379-4452
Mailing address
1308 Greenwood CT
Shakopee, MN 55379-4452
Phone (612) 509-6690
Other practice location 1
10450 185th St W Ste 100
Lakeville, MN 55044-6696
Phone (612) 509-6690
Other practice location 2
427 W Travelers Trail
Burnsville, MN 55337
Phone (952) 247-2954
Other practice location 3
735 3rd St SW
Perham, MN 56573-1152
Phone (218) 214-9950
Other practice location 4
512 30th Ave E Ste 100
Alexandria, MN 56308-5096
Phone (218) 287-4338
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 |
|---|---|---|---|
| RBT-20-146620 | MN | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708387200000",
"number": "1134739279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1308 GREENWOOD CT",
"city": "SHAKOPEE",
"state": "MN",
"postal_code": "553794452",
"telephone_number": "612-509-6690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1308 GREENWOOD CT",
"city": "SHAKOPEE",
"state": "MN",
"postal_code": "553794452",
"telephone_number": "161-235-5652"
}
],
"practiceLocations": [
{
"address_1": "10450 185th St W Ste 100",
"address_purpose": "LOCATION",
"city": "Lakeville",
"state": "MN",
"postal_code": "550446696",
"country_code": "US",
"telephone_number": "612-509-6690",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "427 W Travelers Trail",
"address_purpose": "LOCATION",
"city": "Burnsville",
"state": "MN",
"postal_code": "55337",
"country_code": "US",
"telephone_number": "952-247-2954",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "735 3rd St SW",
"address_purpose": "LOCATION",
"city": "Perham",
"state": "MN",
"postal_code": "565731152",
"country_code": "US",
"telephone_number": "218-214-9950",
"fax_number": "605-271-3956",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "512 30th Ave E Ste 100",
"address_purpose": "LOCATION",
"city": "Alexandria",
"state": "MN",
"postal_code": "563085096",
"country_code": "US",
"telephone_number": "218-287-4338",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NELSON",
"first_name": "JAYMI",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-04",
"last_updated": "2024-02-20",
"certification_date": "2024-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MN",
"license": "1-24-71109",
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MN",
"license": "RBT-20-146620",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shakopee, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.