Individual provider Active NPI

Archana Rajareddy, BCBA

  • Behavior Analyst
  • Jacksonville, FL
National Provider Identifier
1154848166
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-19-37664
Practice address
6820 Southpoint Pkwy Ste 9
Jacksonville, FL 32216-6277
Phone
(888) 754-0398
NPI assigned
Aug 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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 1-19-37664 Primary

Addresses

Primary practice location

6820 Southpoint Pkwy Ste 9
Jacksonville, FL 32216-6277

Mailing address

631 Meadow Creek Dr
Saint Johns, FL 32259-7462
Phone (845) 709-3756

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vocational Development Group, LLC Behavior Analyst Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1154848166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 MEADOW CREEK DR",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322597462",
            "telephone_number": "845-709-3756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6820 SOUTHPOINT PKWY STE 9",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166277",
            "telephone_number": "888-754-0398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJAREDDY",
        "first_name": "ARCHANA",
        "name_prefix": "Ms.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-29",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-19-37664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.

Verify at the official NPI Registry.