NPIMap

Organization Active NPI

Thweatt Advanced Behavior Associates

  • Behavior Analyst
  • Gulfport, MS
National Provider Identifier
1609507961
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
THWEATT ADVANCED BEHAVIOR ASSOCIATES
Doing business as
Thweatt Advanced Behavior Associates
Practice address
708 Broad Ave
Gulfport, MS 39501-1350
Phone
(731) 614-3101
Fax
(228) 300-2113
NPI assigned
Jun 17, 2022
Last updated
Jul 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Ms. Jacqueline Renee Thomas Thweatt-Burton, M.ED., BCBA, LBANPI 1891318986
Title
Executive Director
Phone
(731) 614-3101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

708 Broad Ave
Gulfport, MS 39501-1350

Mailing address

708 Broad Ave
Gulfport, MS 39501-1350
Phone (731) 614-3101

Other practice location 1

530 Scarce Creek Rd
Lexington, TN 38351-8561
Phone (731) 614-3101

Other identifiers 4

IdentifierTypeStateIssuer
0000000623OtherTNTENNESSEE DEPARTMENT OF HEALTH
06888361MedicaidMS
200005OtherMSMISSISSIPPI AUTISM BOARD
LBA0000000627OtherALALABAMA BEHAVIOR ANALYST LICENSING BOARD

Other names 1

  • Thweatt Advanced Behavior Associates Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jthweatt@CBHSaba.org Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1655424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1609507961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 BROAD AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395011350",
            "telephone_number": "731-614-3101",
            "fax_number": "228-300-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 BROAD AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395011350",
            "telephone_number": "731-614-3101",
            "fax_number": "228-300-2113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 Scarce Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "TN",
            "postal_code": "383518561",
            "country_code": "US",
            "telephone_number": "731-614-3101",
            "fax_number": "228-300-2113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THWEATT ADVANCED BEHAVIOR ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-17",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "THWEATT-BURTON",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "RENEE THOMAS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "731-614-3101",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.ED., BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNESSEE DEPARTMENT OF HEALTH",
            "identifier": "0000000623",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06888361",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSISSIPPI AUTISM BOARD",
            "identifier": "200005",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA BEHAVIOR ANALYST LICENSING BOARD",
            "identifier": "LBA0000000627",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jthweatt@CBHSaba.org",
            "affiliation": "N",
            "endpointDescription": "Work email with a BAA Google Workspace",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "708 Broad Ave",
            "city": "Gulfport",
            "state": "MS",
            "country_code": "US",
            "postal_code": "395011350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Thweatt Advanced Behavior Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Thweatt Advanced Behavior Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.