Wyatt Jones, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

702629 Issued in CO

Practice address

4143 Columbia Rd Ste B
Martinez, GA 30907-5405

Phone

(706) 755-2785

NPI assigned

Aug 2, 2021

Last updated

Aug 2, 2021By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Live Oak Behavioral Services, LLC

  • Behavior Analyst
  • Evans, GA
  • NPI 1477040244
  NPD (past)

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1386318657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4143 COLUMBIA RD STE B",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309075405",
            "telephone_number": "706-755-2785",
            "fax_number": "706-755-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4143 COLUMBIA RD STE B",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309075405",
            "telephone_number": "706-755-2785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "WYATT",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CO",
            "license": "702629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priscilla Phan Johnson, PA
• Yvonne Fry Johnson, MD, MSCR
• Kellie Joiner, LMT
• Jasmin Jones
• Tiara Racquel Jones, MS, OTR/L
• K2 Motions LLC (K2 Motions Stretch Therapy)
• Kathryn a Webb DCPC
• Katharine Marie Keaton
• Elizabeth C Kelly
• Dianna N Kendrick, LMT

• Behavior Technician in Martinez, GA
• Providers in Martinez, GA by specialty
• Behavior Technician in Georgia

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