Active NPI
Jessica Goddard
- Behavior Technician
- Abilene, TX
National Provider Identifier
1215588967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 19-99476
- Practice address
- 4606 S 14TH St
Abilene, TX 79605-4735 - Phone
- (325) 829-1804
- NPI assigned
- Sep 24, 2019
- Sex
- Female
- Sole proprietor
- No
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 Technician | 106S00000X | 19-99476 | TX | Primary |
Addresses
Primary practice location
4606 S 14TH St
Abilene, TX 79605-4735
Mailing address
3857 Trinity LN
Abilene, TX 79602-8420
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19-99476 | Other | RBT | |
| 19-99476 | Other | TX | RBT |
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 |
|---|---|---|---|
| 19-99476 | TX | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569283200000",
"number": "1215588967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3857 TRINITY LN",
"city": "ABILENE",
"state": "TX",
"postal_code": "796028420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4606 S 14TH ST",
"city": "ABILENE",
"state": "TX",
"postal_code": "796054735",
"telephone_number": "325-829-1804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GODDARD",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-24",
"last_updated": "2019-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TX",
"license": "19-99476",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RBT",
"identifier": "19-99476",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RBT",
"identifier": "19-99476",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Abilene, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.