Active NPI
Jillian Decker
- Behavior Technician
- Shawnee, KS
National Provider Identifier
1609629401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 11104 W 61St St
Shawnee, KS 66203-2728 - Phone
- (913) 369-4404
- NPI assigned
- Apr 10, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
11104 W 61St St
Shawnee, KS 66203-2728
Mailing address
11104 W 61St St
Shawnee, KS 66203-2728
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712707200000",
"number": "1609629401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11104 W 61ST ST",
"city": "SHAWNEE",
"state": "KS",
"postal_code": "662032728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11104 W 61ST ST",
"city": "SHAWNEE",
"state": "KS",
"postal_code": "662032728",
"telephone_number": "913-369-4404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECKER",
"first_name": "JILLIAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-10",
"last_updated": "2024-04-10",
"certification_date": "2024-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shawnee, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.