Active NPI
Julia Jackson, RBT
- Behavior Technician
- Bloomington, IN
National Provider Identifier
1437831708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-226635
- Practice address
- 4101 E 3Rd St
Bloomington, IN 47401 - Phone
- (812) 747-9384
- NPI assigned
- Aug 4, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | RBT-22-226635 | IN | Primary |
Addresses
Primary practice location
4101 E 3Rd St
Bloomington, IN 47401
Mailing address
2815 E 3Rd St # 1011
Bloomington, IN 47401-5434
Phone (812) 747-9384
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-22-226635 | IN | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691107200000",
"number": "1437831708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2815 E 3RD ST # 1011",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474015434",
"telephone_number": "812-747-9384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4101 E 3RD ST",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "47401",
"telephone_number": "812-747-9384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JULIA",
"credential": "RBT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-04",
"last_updated": "2023-08-04",
"certification_date": "2023-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IN",
"license": "RBT-22-226635",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.