Individual provider Active NPI

Jermaine Shanta Ferebee

  • Behavior Analyst
  • Jacksonville, NC
National Provider Identifier
1174869887
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-21-48283
Practice address
200 Valencia Dr
Jacksonville, NC 28546-6311
Phone
(252) 341-4192
NPI assigned
Dec 27, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1-21-48283 Primary
Developmental Therapist 222Q00000X

Addresses

Primary practice location

200 Valencia Dr
Jacksonville, NC 28546-6311

Mailing address

308 Greenville Blvd SE Ste B1
Greenville, NC 27858-5758
Phone (252) 341-4192

Other practice location 1

308 Greenville Blvd SE Ste B1
Greenville, NC 27858-5758
Phone (252) 341-4192

Other practice location 2

2708 NE 14th St
Suite 5
Pompano Beach, FL 33062-3565
Phone (888) 880-9279

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
Priorities ABA, PLLC Behavior Analyst PastSince Mar 21, 2021 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": "1356566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1174869887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 GREENVILLE BLVD SE STE B1",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585758",
            "telephone_number": "252-341-4192",
            "fax_number": "866-309-9297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 VALENCIA DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466311",
            "telephone_number": "252-341-4192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "308 Greenville Blvd SE Ste B1",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278585758",
            "country_code": "US",
            "telephone_number": "252-341-4192",
            "fax_number": "866-309-9297",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2708 NE 14th St",
            "address_2": "Suite 5",
            "address_purpose": "LOCATION",
            "city": "Pompano Beach",
            "state": "FL",
            "postal_code": "330623565",
            "country_code": "US",
            "telephone_number": "888-880-9279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEREBEE",
        "first_name": "JERMAINE",
        "middle_name": "SHANTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-27",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-21-48283",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.

Verify at the official NPI Registry.