Active NPI
Jessica Ann Herbst
- Behavior Analyst
- Portsmouth, OH
National Provider Identifier
1578113353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 00977
- Practice address
- 1112 Gallia St
Portsmouth, OH 45662-4161 - Phone
- (317) 674-0981
- NPI assigned
- Sep 13, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 00977 | OH | Primary |
| Behavior Analyst | 103K00000X | 287507 | KY |
Addresses
Primary practice location
1112 Gallia St
Portsmouth, OH 45662-4161
Mailing address
810 Dunaway St
Miamisburg, OH 45342-3833
Phone (937) 336-7686
Other practice location 1
810 Dunaway St
Miamisburg, OH 45342-3833
Phone (937) 336-7686
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 287507 | KY | MD | Behavioral Analyst |
| 00977 | OH | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrumcare, LLC. | Behavior Analyst | Past | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697414400000",
"number": "1578113353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 DUNAWAY ST",
"city": "MIAMISBURG",
"state": "OH",
"postal_code": "453423833",
"telephone_number": "937-336-7686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1112 GALLIA ST",
"city": "PORTSMOUTH",
"state": "OH",
"postal_code": "456624161",
"telephone_number": "317-674-0981"
}
],
"practiceLocations": [
{
"address_1": "810 Dunaway St",
"address_purpose": "LOCATION",
"city": "Miamisburg",
"state": "OH",
"postal_code": "453423833",
"country_code": "US",
"telephone_number": "937-336-7686",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HERBST",
"first_name": "JESSICA",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-13",
"last_updated": "2023-10-16",
"certification_date": "2023-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "OH",
"license": "00977",
"primary": true
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "KY",
"license": "287507",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portsmouth, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.