Active NPI
David William Jaques
- Behavior Analyst
- Belleville, IL
National Provider Identifier
1487983508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 900 Royal Heights Rd
Belleville, IL 62226-5457 - Phone
- (618) 277-4100
- Fax
- (618) 277-4355
- NPI assigned
- Dec 19, 2009
- Sex
- Male
- 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 Analyst | 103K00000X | Primary |
Addresses
Primary practice location
900 Royal Heights Rd
Belleville, IL 62226-5457
Mailing address
900 Royal Heights Rd
Belleville, IL 62226-5457
Phone (618) 277-4100
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1261180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261180800000",
"number": "1487983508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 ROYAL HEIGHTS RD",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622265457",
"telephone_number": "618-277-4100",
"fax_number": "618-277-4355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 ROYAL HEIGHTS RD",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622265457",
"telephone_number": "618-277-4100",
"fax_number": "618-277-4355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAQUES",
"first_name": "DAVID",
"middle_name": "WILLIAM",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-12-19",
"last_updated": "2009-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.