Active NPI
Jackie Trimble Brewer, RBT
- Behavior Technician
- Huntington, WV
National Provider Identifier
1255802369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-18-67317
- Practice address
- 10 6TH Ave W
Huntington, WV 25701-0028 - Phone
- (304) 825-8014
- NPI assigned
- Dec 16, 2018
- 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 Technician | 106S00000X | RBT-18-67317 | WV | Primary |
Addresses
Primary practice location
10 6TH Ave W
Huntington, WV 25701-0028
Mailing address
4848 Sammons Rd
Ashland, KY 41101-6916
Phone (606) 205-3261
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-18-67317 | WV | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544918400000",
"number": "1255802369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4848 SAMMONS RD",
"city": "ASHLAND",
"state": "KY",
"postal_code": "411016916",
"telephone_number": "606-205-3261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 6TH AVE W",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257010028",
"telephone_number": "304-825-8014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREWER",
"first_name": "JACKIE",
"middle_name": "TRIMBLE",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-16",
"last_updated": "2018-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "WV",
"license": "RBT-18-67317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.