Active NPI
Sharif Ahkeem Jamal Thomas
- Behavior Technician
- Woburn, MA
National Provider Identifier
1629567151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 3 Fairmount St
Woburn, MA 01801-4203 - Phone
- (781) 439-2179
- NPI assigned
- May 10, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary | ||
| Behavior Technician | 106S00000X | MA |
Addresses
Primary practice location
3 Fairmount St
Woburn, MA 01801-4203
Mailing address
3 Fairmount St
Woburn, MA 01801-4203
Phone (781) 439-2179
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CDW982645665 | Other | BLUE CROSS BLUE SHIELD |
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": "1525910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525910400000",
"number": "1629567151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 FAIRMOUNT ST",
"city": "WOBURN",
"state": "MA",
"postal_code": "018014203",
"telephone_number": "781-439-2179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 FAIRMOUNT ST",
"city": "WOBURN",
"state": "MA",
"postal_code": "018014203",
"telephone_number": "781-439-2179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "SHARIF AHKEEM",
"middle_name": "JAMAL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-05-10",
"last_updated": "2018-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MA",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "CDW982645665",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Woburn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.