Active NPI
Jesse Jordan Davis, RBT
- Behavior Analyst
- Fort Lauderdale, FL
National Provider Identifier
1689424400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BACB1084146
- Practice address
- 2011 NE 60TH St
Fort Lauderdale, FL 33308-2127 - Phone
- (954) 830-9508
- NPI assigned
- Mar 25, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | BACB1084146 | FL | Primary |
Addresses
Primary practice location
2011 NE 60TH St
Fort Lauderdale, FL 33308-2127
Mailing address
2522 Lincoln St Apt 232
Hollywood, FL 33020-4108
Phone (770) 895-7364
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
| License | State | Type | Specialty |
|---|---|---|---|
| BACB1084146 | FL | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711324800000",
"number": "1689424400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2522 LINCOLN ST APT 232",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330204108",
"telephone_number": "770-895-7364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2011 NE 60TH ST",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333082127",
"telephone_number": "954-830-9508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JESSE",
"middle_name": "JORDAN",
"credential": "RBT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-03-25",
"last_updated": "2024-03-25",
"certification_date": "2024-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "BACB1084146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.