Kimberley Graham Jarutowicz, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-13-12822 Issued in TX

Practice address

2525 Ladd St BLDG 3850
Lackland a F B, TX 78236-5308

Phone

(210) 289-7686

Fax

(186) 640-3798

NPI assigned

Apr 14, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Potential Growth

  • Behavior Analyst
  • Floresville, TX
  • NPI 1346661527
  NPD (past) Authorized official
• Potential Growth LLC

  • Behavior Analyst
  • Floresville, TX
  • NPI 1013339076
  NPD (past) Authorized official
• Behavior Keys

  • Behavior Analyst
  • Lackland a F B, TX
  • NPI 1750724118
  NPD (past)

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

{
    "created_epoch": "1365897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365897600000",
    "number": "1386087930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1438 COUNTY ROAD 314",
            "city": "FLORESVILLE",
            "state": "TX",
            "postal_code": "781143340",
            "telephone_number": "210-289-7686",
            "fax_number": "186-640-3798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 LADD ST BLDG 3850",
            "city": "LACKLAND A F B",
            "state": "TX",
            "postal_code": "782365308",
            "telephone_number": "210-289-7686",
            "fax_number": "186-640-3798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARUTOWICZ",
        "first_name": "KIMBERLEY",
        "middle_name": "GRAHAM",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-14",
        "last_updated": "2013-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-13-12822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA CERTIFICATE NUMBER",
            "identifier": "1-13-12822",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Allan Hinton, M.D.
• Charles Edwin Hulshof, LCSW
• John William Hultquist, DMD, MD
• Sharon Melissa Hunter, REGISTERED DIETITIAN
• Rajiv C Iyer, M.D.
• Jeffrey Johnson, PHARMD
• Lori Angela Johnson, M.D.
• Craig Eugene Jordan, PH.D.
• Kristen Kann, M.D.
• Sara Ellen Kennedy, RNC

• Behavior Analyst in Lackland a F B, TX
• Providers in Lackland a F B, TX by specialty
• Behavior Analyst in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2013; 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.