Jordan Brovelli

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

276986 Issued in KY

Practice address

799 E Brannon Rd
Nicholasville, KY 40356-6038

Phone

(859) 224-2273

Fax

(859) 224-4675

NPI assigned

May 23, 2022

Last updated

May 23, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Marshall Pediatric Therapy, LLC

  • Pediatric Occupational Therapist
  • Nicholasville, KY
  • NPI 1104198472
  NPD

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1598403206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 WIND HAVEN DR STE 100",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403568010",
            "telephone_number": "859-224-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 E BRANNON RD",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403566038",
            "telephone_number": "859-224-2273",
            "fax_number": "859-224-4675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3450 Richmond Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405092742",
            "country_code": "US",
            "telephone_number": "859-224-2273",
            "fax_number": "859-224-4675",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "117 E Jefferson St",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "KY",
            "postal_code": "403241764",
            "country_code": "US",
            "telephone_number": "859-224-2273",
            "fax_number": "859-224-4675",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1013 Center Dr",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "KY",
            "postal_code": "404753841",
            "country_code": "US",
            "telephone_number": "859-224-2273",
            "fax_number": "859-224-4675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROVELLI",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "KY",
            "license": "276986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Nicholasville, KY
• Providers in Nicholasville, KY by specialty
• Behavior Analyst in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.

Verify at the official NPI Registry.