Individual provider Active NPI

Jocelyn Blander

  • Behavior Technician
  • Atlanta, GA
National Provider Identifier
1669080503
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-19-78725 Issued in GA
Practice address
5163 Roswell Rd
Atlanta, GA 30342-2206
Phone
(877) 288-4760
NPI assigned
Jul 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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-19-78725 GA Primary

Addresses

Primary practice location

5163 Roswell Rd
Atlanta, GA 30342-2206

Mailing address

205 Lady Helen CT
Fayetteville, GA 30214-3659

Other practice location 1

112 Jefferson street
Newnan, GA 30263
Phone (877) 288-4760

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-19-78725GAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Dogwood Autism Services, LLC CurrentSince Jan 31, 2021 Accepting new patients

Locations

112 Jefferson St
Newnan, GA 30263
Phone (877) 288-4260

5163 Roswell Rd
Sandy Springs, GA 30342
Phone (678) 602-9523

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.

NPI Registry JSON

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1669080503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 LADY HELEN CT",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302143659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5163 ROSWELL RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303422206",
            "telephone_number": "877-288-4760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Jefferson street",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "30263",
            "country_code": "US",
            "telephone_number": "877-288-4760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANDER",
        "first_name": "JOCELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "RBT-19-78725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.