Active NPI
Jessica Nettnin
- Behavior Technician
- Southern Pines, NC
National Provider Identifier
1417517582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 340 Commerce Ave Ste 6
Southern Pines, NC 28387-7115 - Phone
- (910) 688-3646
- NPI assigned
- Jun 19, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
340 Commerce Ave Ste 6
Southern Pines, NC 28387-7115
Mailing address
340 Commerce Ave Ste 6
Southern Pines, NC 28387-7115
Phone (910) 688-3646
Other practice location 1
525 N Tryon St # 1638
Charlotte, NC 28202-0202
Phone (855) 295-3276
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592179200000",
"number": "1417517582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 COMMERCE AVE STE 6",
"city": "SOUTHERN PINES",
"state": "NC",
"postal_code": "283877115",
"telephone_number": "910-688-3646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 COMMERCE AVE STE 6",
"city": "SOUTHERN PINES",
"state": "NC",
"postal_code": "283877115",
"telephone_number": "910-688-3646"
}
],
"practiceLocations": [
{
"address_1": "525 N Tryon St # 1638",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282020202",
"country_code": "US",
"telephone_number": "855-295-3276",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NETTNIN",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-19",
"last_updated": "2020-06-15",
"certification_date": "2020-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southern Pines, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.