Individual provider Active NPI

Jaime Whalley, RBT

  • Behavior Technician
  • Jacksonville, NC
National Provider Identifier
1346834611
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT21-157464 Issued in NC
Practice address
113G N Marine Blvd
Jacksonville, NC 28540-6508
Phone
(910) 389-0901
NPI assigned
Feb 26, 2021
Last updated
Feb 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X RBT21-157464 NC Primary

Addresses

Primary practice location

113G N Marine Blvd
Jacksonville, NC 28540-6508

Mailing address

715 Stonewall Ave
Jacksonville, NC 28540-8837
Phone (765) 427-9943

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
RBT21-157464NCMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Autism Institute-ABA, Inc. CurrentSince May 21, 2023 Accepting new patients

Locations

113G N Marine Blvd
Jacksonville, NC 28540
Phone (910) 389-2790

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": "1614297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1346834611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 STONEWALL AVE",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285408837",
            "telephone_number": "765-427-9943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113G N MARINE BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285406508",
            "telephone_number": "910-389-0901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALLEY",
        "first_name": "JAIME",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-26",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "NC",
            "license": "RBT21-157464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.