Active NPI
James W Jackson, M.S., BCBA
- Behavior Analyst
- New Lenox, IL
National Provider Identifier
1710118625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-07-3553
- Practice address
- 1111 N Cedar Rd
New Lenox, IL 60451-1419 - Phone
- (618) 201-1278
- NPI assigned
- Jul 27, 2009
- Last updated
- Jul 27, 2009
- 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 | 1-07-3553 | IL | Primary |
Addresses
Primary practice location
1111 N Cedar Rd
New Lenox, IL 60451-1419
Mailing address
1111 N Cedar Rd
New Lenox, IL 60451-1419
Phone (618) 201-1278
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248652800000",
"number": "1710118625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 N CEDAR RD",
"city": "NEW LENOX",
"state": "IL",
"postal_code": "604511419",
"telephone_number": "618-201-1278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 N CEDAR RD",
"city": "NEW LENOX",
"state": "IL",
"postal_code": "604511419",
"telephone_number": "618-201-1278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JAMES",
"middle_name": "W",
"name_prefix": "Mr.",
"credential": "M.S., BCBA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-27",
"last_updated": "2009-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IL",
"license": "1-07-3553",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Lenox, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.