Jeremy David Ivy

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-25-419533 Issued in FL

Practice address

12724 Gran Bay Pkwy W Ste 410
Jacksonville, FL 32258-9486

Phone

(912) 202-9037

NPI assigned

Sep 9, 2019

Last updated

Mar 19, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1356990766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 HAMILTON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322057127",
            "telephone_number": "912-202-9037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12724 GRAN BAY PKWY W STE 410",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322589486",
            "telephone_number": "912-202-9037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVY",
        "first_name": "JEREMY",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-09",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-25-419533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisbet Ivicic, NP
• Agnieszka Teresa Ivins
• Patrick Joseph Ivory, PA-C
• Paul Ivory
• Ivps of Jacksonsonville
• Nadia Iwanyshyn
• Amanda Iway, OTR
• Bashyam Iyengar, MD
• Shreya Iyengar
• Olatunbosun Modupe Iyewarun, P.T.

• Behavior Technician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; 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.