Individual provider Active NPI

Justus Bowland-Gleason

  • Behavior Technician
  • Atlanta, GA
National Provider Identifier
1376172460
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1170 Peachtree St NE Ste 1200
Atlanta, GA 30309-7673
Phone
(770) 658-8063
NPI assigned
Apr 2, 2020
Last updated
Apr 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

1170 Peachtree St NE Ste 1200
Atlanta, GA 30309-7673

Mailing address

1605 Fair Haven Dr
Riverdale, GA 30296-2042
Phone (770) 658-8063

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jgleason@momentum-therapy.com

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

NPI Registry JSON

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1376172460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 FAIR HAVEN DR",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302962042",
            "telephone_number": "770-658-8063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 PEACHTREE ST NE STE 1200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303097673",
            "telephone_number": "770-658-8063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWLAND-GLEASON",
        "first_name": "JUSTUS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-02",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgleason@momentum-therapy.com",
            "affiliation": "N",
            "address_1": "1170 Peachtree St NE Ste 1200",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303097673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; 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.