Active NPI
Jacob Mayle
- Behavior Technician
- Allegan, MI
National Provider Identifier
1548890957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 3285 122ND Ave
Allegan, MI 49010-9511 - Phone
- (269) 673-6617
- NPI assigned
- Jan 24, 2020
- 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 | MI | Primary |
Addresses
Primary practice location
3285 122ND Ave
Allegan, MI 49010-9511
Mailing address
4984 W Campus Dr Apt H1
Allendale, MI 49401-8035
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": "1579824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579824000000",
"number": "1548890957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4984 W CAMPUS DR APT H1",
"city": "ALLENDALE",
"state": "MI",
"postal_code": "494018035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3285 122ND AVE",
"city": "ALLEGAN",
"state": "MI",
"postal_code": "490109511",
"telephone_number": "269-673-6617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYLE",
"first_name": "JACOB",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-01-24",
"last_updated": "2020-01-24",
"certification_date": "2020-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allegan, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.