Active NPI
Jasmine Jacobs
- Behavior Technician
- Jenison, MI
National Provider Identifier
1649009580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 1-24-51927
- Practice address
- 8413 Cottonwood Dr
Jenison, MI 49428-8327 - Phone
- (574) 387-4313
- Fax
- (574) 204-2868
- NPI assigned
- Jul 30, 2024
- Sole proprietor
- No
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 | 1-24-51927 | MI | Primary |
Addresses
Primary practice location
8413 Cottonwood Dr
Jenison, MI 49428-8327
Mailing address
215 Red Coach Dr
Mishawaka, IN 46545-8307
Phone (574) 387-4313
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vav Operations Mi, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Kalamazoo, MI
- NPI 1285174912
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722297600000",
"number": "1649009580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 RED COACH DR",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465458307",
"telephone_number": "574-387-4313",
"fax_number": "574-204-2868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8413 COTTONWOOD DR",
"city": "JENISON",
"state": "MI",
"postal_code": "494288327",
"telephone_number": "574-387-4313",
"fax_number": "574-204-2868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "JASMINE",
"sole_proprietor": "NO",
"sex": "U",
"enumeration_date": "2024-07-30",
"last_updated": "2024-07-30",
"certification_date": "2024-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MI",
"license": "1-24-51927",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jenison, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.