Individual provider Active NPI

Jacquanda R Durden

  • Behavior Technician
  • Suwanee, GA
National Provider Identifier
1508453879
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
7360 McGinnis Ferry Rd # 100
Suwanee, GA 30024-6603
Phone
(866) 523-4268
NPI assigned
Dec 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

7360 McGinnis Ferry Rd # 100
Suwanee, GA 30024-6603

Mailing address

1215 Hightower TRL Ste B120
Atlanta, GA 30350-6205
Phone (866) 523-4268

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": "1608508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1508453879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 HIGHTOWER TRL STE B120",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303506205",
            "telephone_number": "866-523-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7360 MCGINNIS FERRY RD # 100",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246603",
            "telephone_number": "866-523-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURDEN",
        "first_name": "JACQUANDA",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-21",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.

Verify at the official NPI Registry.