Individual provider Active NPI

Jordyn Pierce

  • Addiction (Substance Use Disorder) Counselor
  • Dayton, OH
National Provider Identifier
1285259804
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA-175948 Issued in OH
Practice address
2400 W Stroop Rd
Dayton, OH 45439-2041
Phone
(937) 951-1772
NPI assigned
Jun 9, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X CDCA.172222 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA-175948 OH Primary

Addresses

Primary practice location

2400 W Stroop Rd
Dayton, OH 45439-2041

Mailing address

2400 W Stroop Rd
Dayton, OH 45439-2041
Phone (937) 951-1772

Other practice location 1

43 E Babbitt St
Dayton, OH 45405-4903
Phone (937) 253-1680 ext. 93725

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

LicenseStateTypeSpecialty
CDCA-175948OHMDAddiction (Substance Use Disorder) Counselor
CDCA.172222OHMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Behavioral Health, Inc PastSince Jun 1, 2020 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1285259804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 W STROOP RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454392041",
            "telephone_number": "937-951-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 W STROOP RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454392041",
            "telephone_number": "937-951-1772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43 E Babbitt St",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454054903",
            "country_code": "US",
            "telephone_number": "937-253-1680 x93725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIERCE",
        "first_name": "JORDYN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-09",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "OH",
            "license": "CDCA.172222",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA-175948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.