Individual provider Active NPI

Jennifer Lynn Mitchell

  • Behavior Technician
  • Gastonia, NC
National Provider Identifier
1558930032
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
2675 Court Dr # B
Gastonia, NC 28054-1478
Phone
(704) 000-0000
NPI assigned
Jun 21, 2021
Last updated
Jun 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

2675 Court Dr # B
Gastonia, NC 28054-1478

Mailing address

407 W Virginia Ave
Bessemer City, NC 28016-2216
Phone (704) 579-2297

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL Unknown Other
Other URL Unknown Health Information Exchange (HIE)

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": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1558930032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 W VIRGINIA AVE",
            "city": "BESSEMER CITY",
            "state": "NC",
            "postal_code": "280162216",
            "telephone_number": "704-579-2297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 COURT DR # B",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280541478",
            "telephone_number": "704-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Unknown",
            "affiliation": "N",
            "endpointDescription": "Unknown",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Unknown",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "407 W Virginia Ave",
            "city": "Bessemer City",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280162216",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Unknown",
            "affiliation": "N",
            "endpointDescription": "Unknown",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2675 Court Dr # B",
            "city": "Gastonia",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280541478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.