Individual provider Active NPI

Jennifer Elizabeth Rist, BCBA

  • Behavior Analyst
  • Windsor, VT
National Provider Identifier
1144869918
Registry record updated Dec 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
146.0134170 Issued in VT
Practice address
147 Main St
Windsor, VT 05089-1338
Phone
(802) 738-5309
NPI assigned
Dec 27, 2019
Last updated
Dec 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2019

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 146.0134170 VT Primary

Addresses

Primary practice location

147 Main St
Windsor, VT 05089-1338

Mailing address

147 Main St
Windsor, VT 05089-1338
Phone (802) 738-5309

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
146.0134170VTMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1577404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1144869918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 MAIN ST",
            "city": "WINDSOR",
            "state": "VT",
            "postal_code": "050891338",
            "telephone_number": "802-738-5309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 MAIN ST",
            "city": "WINDSOR",
            "state": "VT",
            "postal_code": "050891338",
            "telephone_number": "802-738-5309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIST",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-27",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VT",
            "license": "146.0134170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; 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.