Active NPI
Jenna Duckett, RBT
- Behavior Technician
- Champaign, IL
National Provider Identifier
1225717440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 2301 W Bradley Ave
Champaign, IL 61821-1849 - Phone
- (574) 387-4313
- NPI assigned
- Jul 14, 2023
- 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 | Primary |
Addresses
Primary practice location
2301 W Bradley Ave
Champaign, IL 61821-1849
Mailing address
215 Red Coach Dr
Mishawaka, IN 46545-8307
Phone (574) 387-4313
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vav Operations Il, LLC | Current | Accepting new patients |
Locations
2301 W Bradley Ave
Champaign, IL 61821
Phone (217) 295-2491
215 Red Coach Dr
Mishawaka, IN 46545
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689292800000",
"number": "1225717440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 RED COACH DR",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465458307",
"telephone_number": "574-387-4313",
"fax_number": "574-204-2868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 W BRADLEY AVE",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618211849",
"telephone_number": "574-387-4313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUCKETT",
"first_name": "JENNA",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-14",
"last_updated": "2023-07-14",
"certification_date": "2023-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.