Active NPI
Jenna Banda, M.S., BCBA
- Behavior Analyst
- Round Rock, TX
National Provider Identifier
1487331948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 5885
- Practice address
- 1516 E Palm Valley Blvd
Round Rock, TX 78664-4619 - Phone
- (512) 733-2800
- NPI assigned
- Jun 28, 2023
- Last updated
- Jun 28, 2023
- 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 Analyst | 103K00000X | 5885 | TX | Primary |
Addresses
Primary practice location
1516 E Palm Valley Blvd
Round Rock, TX 78664-4619
Mailing address
11420 Powder Mill TRL
Austin, TX 78750-1081
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5885 | TX | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Austin Connect to Wellness, LLC | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687910400000",
"number": "1487331948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11420 POWDER MILL TRL",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787501081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1516 E PALM VALLEY BLVD",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786644619",
"telephone_number": "512-733-2800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANDA",
"first_name": "JENNA",
"credential": "M.S., BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-28",
"last_updated": "2023-06-28",
"certification_date": "2023-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "5885",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Round Rock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.