Individual provider Active NPI

Jordan Karlson, BCBA

  • Behavior Analyst
  • Sioux City, IA
National Provider Identifier
1396406930
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
114647 Issued in IA
Practice address
4280 Sergeant Rd Ste 230
Sioux City, IA 51106-4634
Phone
(605) 952-0551
NPI assigned
Jan 5, 2022
Last updated
Jul 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 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 114647 IA Primary

Addresses

Primary practice location

4280 Sergeant Rd Ste 230
Sioux City, IA 51106-4634

Mailing address

30882 472ND Ave
Beresford, SD 57004-6908
Phone (605) 777-9995

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

State licenses

LicenseStateTypeSpecialty
114647IAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1396406930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30882 472ND AVE",
            "city": "BERESFORD",
            "state": "SD",
            "postal_code": "570046908",
            "telephone_number": "605-777-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 SERGEANT RD STE 230",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511064634",
            "telephone_number": "605-952-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARLSON",
        "first_name": "JORDAN",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-05",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IA",
            "license": "114647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.