Individual provider Active NPI

Joshua William Guernsey

  • Behavior Technician
  • Brooklyn Park, MN
National Provider Identifier
1578049516
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
6900 78TH Ave N Ste 101
Brooklyn Park, MN 55445
Phone
(763) 432-6875
Fax
(763) 432-6894
NPI assigned
Jul 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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 MN Primary

Addresses

Primary practice location

6900 78TH Ave N Ste 101
Brooklyn Park, MN 55445

Mailing address

6900 78TH Ave N Ste 101
Brooklyn Park, MN 55445-2719
Phone (763) 432-6875

Other practice location 1

1522 E Superior St
Duluth, MN 55812-1634
Phone (218) 724-3122

Other practice location 2

1522 E Superior St
Duluth, MN 55812-1634
Phone (218) 724-3122

Other identifiers 1

IdentifierTypeStateIssuer
1417023458MedicaidMN

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

Practice roles

OrganizationSpecialtyStatusNew patients
Accend Services Incorporated PastSince Oct 25, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1578049516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 78TH AVE N STE 101",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554452719",
            "telephone_number": "763-432-6875",
            "fax_number": "763-432-6894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 78TH AVE N STE 101",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "55445",
            "telephone_number": "763-432-6875",
            "fax_number": "763-432-6894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1522 E Superior St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558121634",
            "country_code": "US",
            "telephone_number": "218-724-3122",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1522 E Superior St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558121634",
            "country_code": "US",
            "telephone_number": "218-724-3122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUERNSEY",
        "first_name": "JOSHUA",
        "middle_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-12",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417023458",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; 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.