Active NPI
Emric Javan Jackson, RBT
- Behavior Technician
- Las Vegas, NV
National Provider Identifier
1497535520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT3777
- Practice address
- 8064 W Sahara Ave Ste 100
Las Vegas, NV 89117-1998 - Phone
- (702) 829-8929
- NPI assigned
- Oct 5, 2023
- Sex
- Male
- 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 Technician | 106S00000X | RBT3777 | NV | Primary |
Addresses
Primary practice location
8064 W Sahara Ave Ste 100
Las Vegas, NV 89117-1998
Mailing address
5163 Indian River Dr Unit 194
Las Vegas, NV 89103-6142
Phone (678) 948-8822
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 |
|---|---|---|---|
| RBT3777 | NV | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696464000000",
"number": "1497535520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5163 INDIAN RIVER DR UNIT 194",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891036142",
"telephone_number": "678-948-8822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8064 W SAHARA AVE STE 100",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891171998",
"telephone_number": "702-829-8929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "EMRIC",
"middle_name": "JAVAN",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-10-05",
"last_updated": "2023-10-05",
"certification_date": "2023-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NV",
"license": "RBT3777",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.