Active NPI
Jenna Baine, LBA, BCBA, RBT
- Behavior Analyst
- Memphis, TN
National Provider Identifier
1578130522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 928
- Practice address
- 6413 Quince Rd
Memphis, TN 38119-8219 - Phone
- (901) 690-5213
- Fax
- (901) 666-8440
- NPI assigned
- Jun 8, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Behavior Technician | 106S00000X | RBT-21-171312 | TN | |
| Behavior Analyst | 103K00000X | 928 | TN | Primary |
Addresses
Primary practice location
6413 Quince Rd
Memphis, TN 38119-8219
Mailing address
6413 Quince Rd
Memphis, TN 38119-8219
Phone (901) 690-5213
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RBT-21-171312 | Other | TN | BACB |
| 928 | Other | TN | DEPARTMENT OF HEALTH LICENSURE TN |
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 |
|---|---|---|---|
| 928 | TN | MD | Behavioral Analyst |
| RBT-21-171312 | TN | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hopebridge 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.
-
- Child & Adolescent Psychiatry Physician
- Brentwood, TN
- NPI 1881352177
Behavior Analyst
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646956800000",
"number": "1578130522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6413 QUINCE RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381198219",
"telephone_number": "901-690-5213",
"fax_number": "901-666-8440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6413 QUINCE RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381198219",
"telephone_number": "901-690-5213",
"fax_number": "901-666-8440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAINE",
"first_name": "JENNA",
"credential": "LBA, BCBA, RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-08",
"last_updated": "2022-03-11",
"certification_date": "2022-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TN",
"license": "RBT-21-171312",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TN",
"license": "928",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BACB",
"identifier": "RBT-21-171312",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF HEALTH LICENSURE TN",
"identifier": "928",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.