Active NPI
Jacob Gowler, BCBA
- Behavior Analyst
- Lawrenceville, GA
National Provider Identifier
1225647357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-19-38796
- Practice address
- 1755 N Brown Rd
Suite 200
Lawrenceville, GA 30043-2018 - Phone
- (770) 637-2001
- NPI assigned
- Jul 24, 2020
- Sex
- Male
- 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 Analyst | 103K00000X | 1-19-38796 | Primary |
Addresses
Primary practice location
1755 N Brown Rd
Suite 200
Lawrenceville, GA 30043-2018
Mailing address
1755 North Brown Road
Suite 200
Lawrenceville, GA 30043
Phone (770) 637-2001
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595548800000",
"number": "1225647357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1755 NORTH BROWN ROAD",
"address_2": "SUITE 200",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "30043",
"telephone_number": "770-637-2001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1755 N BROWN RD",
"address_2": "SUITE 200",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300432018",
"telephone_number": "770-637-2001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOWLER",
"first_name": "JACOB",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-24",
"last_updated": "2020-07-24",
"certification_date": "2020-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-19-38796",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.