Individual provider Active NPI

Jade Lynn Ditzel

  • Assistant Behavior Analyst
  • Denver, CO
National Provider Identifier
1427583228
Registry record updated Apr 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
162111052 Issued in CO
Practice address
2131 Lawrence St
#529
Denver, CO 80205-2349
Phone
(720) 512-1139
NPI assigned
Apr 29, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X 162111052 CO Primary

Addresses

Primary practice location

2131 Lawrence St
#529
Denver, CO 80205-2349

Mailing address

2131 Lawrence St
#529
Denver, CO 80205-2349
Phone (720) 512-1139

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
162111052COMDAssistant Behavior Analyst

NPI Registry JSON

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

{
    "created_epoch": "1493424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493424000000",
    "number": "1427583228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 LAWRENCE ST",
            "address_2": "#529",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802052349",
            "telephone_number": "720-512-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 LAWRENCE ST",
            "address_2": "#529",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802052349",
            "telephone_number": "720-512-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITZEL",
        "first_name": "JADE",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-29",
        "last_updated": "2017-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "CO",
            "license": "162111052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2017; 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.