Active NPI
Jarrod Fennell
- Behavior Technician
- Washington, DC
National Provider Identifier
1508417775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 3814 12TH St NE
Washington, DC 20017-2630 - Phone
- (202) 290-7319
- NPI assigned
- Sep 27, 2019
- 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 Technician | 106S00000X | Primary |
Addresses
Primary practice location
3814 12TH St NE
Washington, DC 20017-2630
Mailing address
429 Kennedy St NE
Washington, DC 20011-2648
Phone (202) 597-2473
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569542400000",
"number": "1508417775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "429 KENNEDY ST NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200112648",
"telephone_number": "202-597-2473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3814 12TH ST NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200172630",
"telephone_number": "202-290-7319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENNELL",
"first_name": "JARROD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-27",
"last_updated": "2019-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.