Individual provider Active NPI

Jennifer Donnelly

  • Behavior Analyst
  • Somerset, KY
National Provider Identifier
1285279463
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
11938379 Issued in KY
Practice address
303 Second St
Somerset, KY 42501-2390
Phone
(606) 677-1166
NPI assigned
Nov 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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 11938379 KY Primary

Addresses

Primary practice location

303 Second St
Somerset, KY 42501-2390

Mailing address

517 Golden Eagle Dr
London, KY 40744-9381
Phone (606) 224-2610

Other practice location 1

8706 S US Highway 25
Corbin, KY 40701-4974
Phone (606) 677-1166

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
11938379KYMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Brighter Futures Therapy Center, LLC Behavior Analyst CurrentSince Nov 17, 2019 Accepting new patients
Apollo Behavior Services LLC Behavior Analyst Past Accepting new patients

Locations

303 Second St
Somerset, KY 42501
Phone (606) 679-1166

Organizations & group practices 2

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": "1573516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1285279463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 GOLDEN EAGLE DR",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407449381",
            "telephone_number": "606-224-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 SECOND ST",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425012390",
            "telephone_number": "606-677-1166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8706 S US Highway 25",
            "address_purpose": "LOCATION",
            "city": "Corbin",
            "state": "KY",
            "postal_code": "407014974",
            "country_code": "US",
            "telephone_number": "606-677-1166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-12",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "KY",
            "license": "11938379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; 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.