Jessica Lynn Ryan, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

2017026579 Issued in MO

Practice address

2930 Maguire Rd
Ocoee, FL 34761-4750

Phone

(866) 610-0580

NPI assigned

Dec 9, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Howard Park Early Intervention Center

  • Voluntary or Charitable Agency
  • Fenton, MO
  • NPI 1396739124
  NPD (past)

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1447528070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 INTERNATIONAL PKWY STE 200",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465028",
            "telephone_number": "866-610-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 MAGUIRE RD",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614750",
            "telephone_number": "866-610-0580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2708 NE 14th St",
            "address_2": "Suite 5",
            "address_purpose": "LOCATION",
            "city": "Pompano Beach",
            "state": "FL",
            "postal_code": "330623565",
            "country_code": "US",
            "telephone_number": "888-880-9270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16375 Pierside Ln",
            "address_purpose": "LOCATION",
            "city": "Grover",
            "state": "MO",
            "postal_code": "630401600",
            "country_code": "US",
            "telephone_number": "636-405-2701",
            "fax_number": "636-422-1223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-09",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "2017026579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jared Joseph Roth, P.T.,D.P.T.
• Nicholas Rothstein, DPT
• Roxanne Achong OD, PA
• Ruby Valley Investments, PLLC
• Shea-Racquel Russell
• N Thomas Ryan, MD
• S & T Enterprises of Tampa Inc
• Ammar Saati, M.D.
• Raja Naveed Imran Sadiq, MD
• Priyanka Saigal, M.D.

• Behavior Analyst in Ocoee, FL
• Providers in Ocoee, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; 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.