Active NPI
Nicketa Vesteria Holmes, RBT
- Behavior Analyst
- Manassas, VA
National Provider Identifier
1235612391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- RBT-18-59210
- Practice address
- 7730 Donegan Dr
Manassas, VA 20109-2868 - Phone
- (571) 208-0592
- NPI assigned
- Sep 13, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | RBT-18-59210 | VA | Primary |
Addresses
Primary practice location
7730 Donegan Dr
Manassas, VA 20109-2868
Mailing address
8184 Community Dr
Manassas, VA 20109-3551
Phone (571) 316-6536
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 |
|---|---|---|---|
| RBT-18-59210 | VA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536796800000",
"number": "1235612391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8184 COMMUNITY DR",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201093551",
"telephone_number": "571-316-6536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7730 DONEGAN DR",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201092868",
"telephone_number": "571-208-0592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMES",
"first_name": "NICKETA",
"middle_name": "VESTERIA",
"credential": "RBT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-13",
"last_updated": "2018-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "VA",
"license": "RBT-18-59210",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manassas, VA
- Gabriel Holley
- Barbara Holloway-Toliver, PHYSICIAN ASSISTANT
- Jessica S Holm, PSY.D.
- Adrian Holmes, MS/QMHP-A/LPC-E
- Kristin Ranee Holmes, R.N
- Bahar F Holzemer
- Home Care and Nursing Solutions, LLC
- Home First Counseling and Consultation, LLC
- Home Health Care of Manassas Incorporated
- Home Health Services LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.