Individual provider Active NPI

Jocelaine Smith

  • Behavior Technician
  • Byron, GA
National Provider Identifier
1164918025
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
18-57667 Issued in GA
Practice address
6015 Watson Blvd Ste 330-340
Byron, GA 31008-6650
Phone
(478) 225-3880
NPI assigned
Jul 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 18-57667 GA Primary

Addresses

Primary practice location

6015 Watson Blvd Ste 330-340
Byron, GA 31008-6650

Mailing address

2580 Lin DO CT
Sumter, SC 29150-1832
Phone (803) 905-4427

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
18-57667GAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1164918025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 LIN DO CT",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501832",
            "telephone_number": "803-905-4427",
            "fax_number": "803-905-4431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 WATSON BLVD STE 330-340",
            "city": "BYRON",
            "state": "GA",
            "postal_code": "310086650",
            "telephone_number": "478-225-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOCELAINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-03",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "18-57667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Byron, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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.