Individual provider Active NPI

Abbigail Jett

  • Behavior Technician
  • Saint Louis, MO
National Provider Identifier
1619708872
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-24-330685 Issued in MO
Practice address
11780 Borman Dr
Saint Louis, MO 63146-4135
Phone
(314) 275-0506
NPI assigned
Aug 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-24-330685 MO Primary

Addresses

Primary practice location

11780 Borman Dr
Saint Louis, MO 63146-4135

Mailing address

10767 Faraday Dr
Saint Louis, MO 63123-6038
Phone (314) 756-3359

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
RBT-24-330685MOMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1619708872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10767 FARADAY DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631236038",
            "telephone_number": "314-756-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11780 BORMAN DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464135",
            "telephone_number": "314-275-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETT",
        "first_name": "ABBIGAIL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MO",
            "license": "RBT-24-330685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.

Verify at the official NPI Registry.