Jesse Blain I – Behavior Technician in Rockledge, FL

Key facts

NPI: 1689199762
Entity type: Individual (NPI type 1)
Primary specialty: Behavior Technician 106S00000X
Practice address: 550 Solutions Way
Rockledge, FL 32955-3620
Phone: (321) 639-9800
Fax: (321) 639-6007
NPI assigned: Aug 9, 2017
Sex: Male
Sole proprietor: Yes

Organizations & group practices 2

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.

Behavior Services of Brevard County Behavior Analyst · Rockledge, FL · NPI 1750828323

NPD (past)
Behavior Services of Brevard, Inc. Behavior Analyst · Rockledge, FL · NPI 1548464423

NPD (past) BEHAVIOR TECHNICIAN

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Behavior Services of Brevard, Inc.	Behavior Technician	Past since Jul 24, 2022	Accepting new patients
Behavior Services of Brevard County		Past since Jul 24, 2022	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Behavior Technician	106S00000X			Yes

Addresses

Primary practice location

550 Solutions Way
Rockledge, FL 32955-3620

Mailing address

550 Solutions Way
Rockledge, FL 32955-3620
Phone (321) 639-9800

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689199762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 SOLUTIONS WAY",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553620",
            "telephone_number": "321-639-9800",
            "fax_number": "321-639-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 SOLUTIONS WAY",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553620",
            "telephone_number": "321-639-9800",
            "fax_number": "321-639-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIN",
        "first_name": "JESSE",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

All providers in Rockledge, FL · Behavior Technician in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.