Individual provider Active NPI

Cosme Jaimes

  • Behavior Analyst
  • Salem, OR
National Provider Identifier
1164063780
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
3494 Liberty Rd S
Salem, OR 97302-4607
Phone
(971) 304-0660
NPI assigned
Oct 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 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 Primary

Addresses

Primary practice location

3494 Liberty Rd S
Salem, OR 97302-4607

Mailing address

5858 Poppy Hills St SE
Salem, OR 97306-9011
Phone (626) 230-8110

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

NPI Registry JSON

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1164063780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5858 POPPY HILLS ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973069011",
            "telephone_number": "626-230-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3494 LIBERTY RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024607",
            "telephone_number": "971-304-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIMES",
        "first_name": "COSME",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-04",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.