Active NPI
Jayoniece Tara Brooks, BCBA
- Behavior Analyst
- Winston Salem, NC
National Provider Identifier
1487199964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-20-43684
- Practice address
- 905 Friedberg Church Rd
Winston Salem, NC 27127-9803 - Phone
- (336) 251-1180
- NPI assigned
- Dec 20, 2016
- Last updated
- Oct 2, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-20-43684 | NU | Primary |
| Behavior Technician | 106S00000X | NU |
Addresses
Primary practice location
905 Friedberg Church Rd
Winston Salem, NC 27127-9803
Mailing address
905 Friedberg Church Rd
Winston Salem, NC 27127-9803
Phone (336) 251-1180
Other practice location 1
421 Fayetteville St
Suite 1100
Raleigh, NC 27601-1792
Phone (888) 880-9270
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mosaic Group, LLC | Behavior Analyst | Past | Accepting new patients |
| Abc of NC Child Development Center | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Early Intervention Provider Agency
- Winston Salem, NC
- NPI 1922277417
Behavior Analyst
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1482192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601596800000",
"number": "1487199964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 FRIEDBERG CHURCH RD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271279803",
"telephone_number": "336-251-1180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 FRIEDBERG CHURCH RD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271279803",
"telephone_number": "336-251-1180"
}
],
"practiceLocations": [
{
"address_1": "421 Fayetteville St",
"address_2": "Suite 1100",
"address_purpose": "LOCATION",
"city": "Raleigh",
"state": "NC",
"postal_code": "276011792",
"country_code": "US",
"telephone_number": "888-880-9270",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROOKS",
"first_name": "JAYONIECE",
"middle_name": "TARA",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-20",
"last_updated": "2020-10-02",
"certification_date": "2020-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NU",
"license": "1-20-43684",
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.