Active NPI
Jessika Rebekkah Green
- Behavior Analyst
- Jacksonville, FL
National Provider Identifier
1699205674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 5776 Saint Augustine Rd
Jacksonville, FL 32207-8046 - Phone
- (904) 448-4700
- Fax
- (904) 488-4717
- NPI assigned
- Jun 13, 2017
- Reactivated
- Apr 22, 2026
- Sex
- Female
- Sole proprietor
- No
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 Analyst | 103K00000X | Primary | ||
| Counselor | 101Y00000X | 27483 | FL |
Addresses
Primary practice location
5776 Saint Augustine Rd
Jacksonville, FL 32207-8046
Mailing address
5776 Saint Augustine Rd
Jacksonville, FL 32207-8046
Phone (904) 448-4700
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 |
|---|---|---|---|
| 27483 | FL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778198400000",
"number": "1699205674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5776 SAINT AUGUSTINE RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078046",
"telephone_number": "904-448-4700",
"fax_number": "904-488-4717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5776 SAINT AUGUSTINE RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078046",
"telephone_number": "904-448-4700",
"fax_number": "904-488-4717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "JESSIKA",
"middle_name": "REBEKKAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-13",
"last_updated": "2026-05-08",
"certification_date": "2026-05-08",
"deactivation_date": "2021-07-06",
"reactivation_date": "2026-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "FL",
"license": "27483",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.