Individual provider Active NPI

Jennifer A Agganis, EDD, BCBA

  • Behavior Analyst
  • Palm City, FL
National Provider Identifier
1578879029
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1031181 Issued in FL
Practice address
1765 SW Captains PL
Palm City, FL 34990-1747
Phone
(772) 266-8727
Fax
(772) 494-7093
NPI assigned
Aug 22, 2010
Last updated
Oct 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1031181 FL Primary

Addresses

Primary practice location

1765 SW Captains PL
Palm City, FL 34990-1747

Mailing address

1765 SW Captains PL
Palm City, FL 34990-1747
Phone (772) 266-8727

Other practice location 1

1806 SE Indian St
Stuart, FL 34997-4919
Phone (772) 266-8727

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

LicenseStateTypeSpecialty
1031181FLMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Simplyaba, LLC Behavior Analyst PastSince Nov 1, 2019 Accepting new patients
My Favorite Therapists, LLC Behavior Analyst PastSince Sep 1, 2019 Accepting new patients

Organizations & group practices 2

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": "1282435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1578879029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 SW CAPTAINS PL",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349901747",
            "telephone_number": "772-266-8727",
            "fax_number": "772-494-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1765 SW CAPTAINS PL",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349901747",
            "telephone_number": "772-266-8727",
            "fax_number": "772-494-7093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1806 SE Indian St",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "FL",
            "postal_code": "349974919",
            "country_code": "US",
            "telephone_number": "772-266-8727",
            "fax_number": "772-494-7093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGGANIS",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "EDD, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-22",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1031181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; 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.