Individual provider Active NPI

Jasmin Jetie Tyree, MHS-C , LBS

  • Behavior Analyst
  • Philadelphia, PA
National Provider Identifier
1700486321
Registry record updated Apr 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
109 S 63Rd St
Philadelphia, PA 19139-2929
Phone
(215) 913-3874
NPI assigned
Nov 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

109 S 63Rd St
Philadelphia, PA 19139-2929

Mailing address

109 S 63Rd St
Philadelphia, PA 19139-2929
Phone (215) 913-3874

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jasmin.santana@hotmail.com Direct

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

NPI Registry JSON

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

{
    "created_epoch": "1604188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618012800000",
    "number": "1700486321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 S 63RD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191392929",
            "telephone_number": "215-913-3874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S 63RD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191392929",
            "telephone_number": "215-913-3874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYREE",
        "first_name": "JASMIN",
        "middle_name": "JETIE",
        "credential": "MHS-C , LBS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-01",
        "last_updated": "2021-04-10",
        "certification_date": "2021-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jasmin.santana@hotmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "109 S 63rd St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191392929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2021; 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.