NPIMap

Individual provider Active NPI

Jeffrey Dickinson

  • Behavior Analyst
  • Secane, PA
National Provider Identifier
1235897448
Registry record updated Dec 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-20-46809 Issued in PA
Practice address
914 South Ave Apt C14
Secane, PA 19018-4463
Phone
(215) 626-7881
NPI assigned
Dec 4, 2021
Last updated
Dec 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-20-46809 PA Primary

Addresses

Primary practice location

914 South Ave Apt C14
Secane, PA 19018-4463

Mailing address

500 Office Center Dr Ste 100
Fort Washington, PA 19034-3234

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

OrganizationSpecialtyStatusNew patients
Analytic Behavioral Services Behavior Analyst Current Accepting new patients

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": "1638576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638576000000",
    "number": "1235897448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 OFFICE CENTER DR STE 100",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190343234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 SOUTH AVE APT C14",
            "city": "SECANE",
            "state": "PA",
            "postal_code": "190184463",
            "telephone_number": "215-626-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "JEFFREY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-04",
        "last_updated": "2021-12-04",
        "certification_date": "2021-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "1-20-46809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Secane, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2021; 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.