Individual provider Active NPI

Jennifer Casey Gregory, BCBA

  • Behavior Analyst
  • Charlotte, NC
National Provider Identifier
1386924454
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-16-23769 Issued in NU
Practice address
2810 Coliseum Centre Dr Ste 520
Charlotte, NC 28217-3345
Phone
(980) 785-1113
NPI assigned
Aug 22, 2011
Last updated
Dec 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-16-23769 NU Primary

Addresses

Primary practice location

2810 Coliseum Centre Dr Ste 520
Charlotte, NC 28217-3345

Mailing address

2810 Coliseum Centre Dr Ste 520
Charlotte, NC 28217-3345
Phone (980) 785-1113

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
Mosaic Group, LLC Behavior Analyst CurrentSince Dec 24, 2023 Accepting new patients

Locations

2810 Coliseum Centre Dr
Ste 520
Charlotte, NC 28217

600 Towne Centre Blvd
Ste 403
Pineville, NC 28134

14321 Winter Breeze Dr
Ste 91
Midlothian, VA 23113
Phone 9807851113 ext. 123

5153 Craig Rath Blvd
Midlothian, VA 23112
Phone (804) 544-9044

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1386924454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 COLISEUM CENTRE DR STE 520",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282173345",
            "telephone_number": "980-785-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 COLISEUM CENTRE DR STE 520",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282173345",
            "telephone_number": "980-785-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "JENNIFER",
        "middle_name": "CASEY",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-22",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": "1-16-23769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.