Individual provider Active NPI

Joshua Grant

  • Behavior Technician
  • Tulsa, OK
National Provider Identifier
1205460409
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
3015 E Skelly Dr Ste 395
Tulsa, OK 74105-6317
Phone
(918) 764-8378
NPI assigned
Feb 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 20109867 OK
Behavior Technician 106S00000X OK Primary

Addresses

Primary practice location

3015 E Skelly Dr Ste 395
Tulsa, OK 74105-6317

Mailing address

2042 E 51St St Apt a
Tulsa, OK 74105-5824
Phone (918) 399-2532

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
20109867OKMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Momentum Learning LLC Behavior Analyst CurrentSince Aug 6, 2023 Accepting new patients
Good Shepherd Catholic School at Mercy Behavior Analyst PastSince Mar 1, 2020 Accepting new patients

Locations

3015 E Skelly Dr
Ste 395
Tulsa, OK 74105
Phone (918) 764-8378

Organizations & group practices 2

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": "1582675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1205460409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2042 E 51ST ST APT A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741055824",
            "telephone_number": "918-399-2532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 E SKELLY DR STE 395",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741056317",
            "telephone_number": "918-764-8378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "JOSHUA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-26",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OK",
            "license": "20109867",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; 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.