Jaquae Andrell Holmes

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

5163 Roswell Rd
Sandy Springs, GA 30342-2206

Phone

(877) 288-4760

NPI assigned

Nov 15, 2022

Last updated

Nov 15, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dogwood Autism Services, LLC

  • Behavior Analyst
  • Atlanta, GA
  • NPI 1437674587
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1548979917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 SUMMIT LN SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300083268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5163 ROSWELL RD",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303422206",
            "telephone_number": "877-288-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "JAQUAE",
        "middle_name": "ANDRELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-15",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert D Hoff, MD
• Taylor Holbrook, RN
• Heather Lynn Hufnagel Holden
• Holistic Integrative Therapy Services LLC
• Wyakemia Holliday
• Fela T Holt, M.S.
• Holy Spirit Phlebotomy Lab LLC
• Kaleigh Karl Holyfield
• Zach Holzman
• Sara Hong, MA, LPC

• Behavior Technician in Sandy Springs, GA
• Providers in Sandy Springs, GA by specialty
• Behavior Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.