Individual provider Active NPI

Jaime Wyman, BCBA

  • Behavior Analyst
  • Colorado Springs, CO
National Provider Identifier
1386005437
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-19-39994
Practice address
5446 N Academy Blvd Ste 204
Colorado Springs, CO 80918-3669
Phone
(719) 598-5555
NPI assigned
Mar 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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
Behavior Analyst 103K00000X 1-19-39994 Primary

Addresses

Primary practice location

5446 N Academy Blvd Ste 204
Colorado Springs, CO 80918-3669

Mailing address

5446 N Academy Blvd Ste 204
Colorado Springs, CO 80918-3669
Phone (719) 598-5555

Other practice location 1

500 Fairway Dr Ste 102
Deerfield Beach, FL 33441-1817
Phone (888) 880-9270

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellcare Inc. Behavior Analyst CurrentSince Jan 5, 2020 Accepting new patients
Nurture Home Health Care Inc PastSince Jun 1, 2020 Accepting new patients

Locations

5446 N Academy Blvd
Ste 204
Colorado Springs, CO 80918
Phone (719) 400-7612

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1386005437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5446 N ACADEMY BLVD STE 204",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183669",
            "telephone_number": "719-598-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5446 N ACADEMY BLVD STE 204",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183669",
            "telephone_number": "719-598-5555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Fairway Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Deerfield Beach",
            "state": "FL",
            "postal_code": "334411817",
            "country_code": "US",
            "telephone_number": "888-880-9270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYMAN",
        "first_name": "JAIME",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-17",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-19-39994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.