Jessica Camacho

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

743 E Tennessee St
Tallahassee, FL 32308-4913

Phone

(786) 897-4418

NPI assigned

Oct 29, 2015

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 identifiers 1

Other names 1

• Jessica Ortiz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Village ABA Therapy LLC

  • Behavior Analyst
  • Tallahassee, FL
  • NPI 1952099608
  NPD Authorized official

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1144692153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 E TENNESSEE ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084913",
            "telephone_number": "786-897-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 E TENNESSEE ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084913",
            "telephone_number": "786-897-4418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11755 SW 90th St",
            "address_2": "SUITE 210",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331862177",
            "country_code": "US",
            "telephone_number": "305-846-9807",
            "fax_number": "305-846-9711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15067 SW 96th Ter",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331961235",
            "country_code": "US",
            "telephone_number": "786-897-4418",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8001 SW 36th St Ste 9",
            "address_purpose": "LOCATION",
            "city": "Davie",
            "state": "FL",
            "postal_code": "33328",
            "country_code": "US",
            "telephone_number": "954-577-7790",
            "fax_number": "954-577-7780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-29",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952099608",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "ORTIZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kinsey Callaway, ARNP
• Erin Callender, LMHC
• Earl Calloway Jr.
• Kylen Callum
• Karen D Calvert
• Roberto Camacho
• Saige Y Camacho
• Katia M Camargo
• Camelot Community Care, Inc
• Camelot Community Care, Inc

• All providers in Tallahassee, FL
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.