Active NPI
Mary Jo Zinnanti
- Behavior Analyst
- Kingsport, TN
National Provider Identifier
1174102131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 748
- Practice address
- 2004 American Way Ste 109
Kingsport, TN 37660-5892 - Phone
- (423) 530-7600
- NPI assigned
- Apr 6, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 748 | TN | Primary |
Addresses
Primary practice location
2004 American Way Ste 109
Kingsport, TN 37660-5892
Mailing address
107 Kinchloe CT
Jonesborough, TN 37659-3062
Phone (865) 806-3190
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
| License | State | Type | Specialty |
|---|---|---|---|
| 748 | TN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Common Thread ABA 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.
-
- Behavior Analyst
- Kingsport, TN
- NPI 1144857764
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617667200000",
"number": "1174102131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 KINCHLOE CT",
"city": "JONESBOROUGH",
"state": "TN",
"postal_code": "376593062",
"telephone_number": "865-806-3190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2004 AMERICAN WAY STE 109",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376605892",
"telephone_number": "423-530-7600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZINNANTI",
"first_name": "MARY JO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-06",
"last_updated": "2021-04-06",
"certification_date": "2021-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TN",
"license": "748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingsport, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.