Jordan Breanne Johnson Bethea, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-17-28399 Issued in AR

Practice address

2418 E Joyce Blvd
Fayetteville, AR 72703-4519

Phone

(479) 871-7994

NPI assigned

Jan 5, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1515110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515110400000",
    "number": "1699282137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3875 WATERHOLE AVE",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727646733",
            "telephone_number": "843-240-1371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 E JOYCE BLVD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034519",
            "telephone_number": "479-871-7994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON BETHEA",
        "first_name": "JORDAN",
        "middle_name": "BREANNE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-05",
        "last_updated": "2018-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AR",
            "license": "1-17-28399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John N Marr PHD PA
• John Shuler LCSW PLLC
• Matt Ryan John, MHPP
• Ravonne John, APRN
• Ashley Nikole Johns
• Johnson Chiropractic Center, LLC
• Johnson Prosthetics & Orthotics LLC
• Abigail Speights Johnson, APRN-PMHNP
• Allison M Johnson, M.D.
• Amanda Kelly Johnson, P.T., D.P.T.

• Behavior Analyst in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Behavior Analyst in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2018; 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.