Individual provider Active NPI

Jessica Hall

  • Assistant Behavior Analyst
  • Palm City, FL
National Provider Identifier
1710242524
Registry record updated May 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
0-17-7942 Issued in FL
Practice address
2843 SW Mill Creek Way
Palm City, FL 34990
Phone
(318) 547-2456
Fax
(318) 547-2456
NPI assigned
Jul 8, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X 0-17-7942 FL Primary

Addresses

Primary practice location

2843 SW Mill Creek Way
Palm City, FL 34990

Mailing address

2843 SW Mill Creek Way
Palm City, FL 34990-3196
Phone (318) 547-2456

Other practice location 1

8108 SE Coconut St
Hobe Sound, FL 33455-4008
Phone (561) 312-3940

Other identifiers 1

IdentifierTypeStateIssuer
1111OtherXXX

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

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Behavior Supports Corp Past Accepting new patients
Treasure Coast ABA Services Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1341705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527552000000",
    "number": "1710242524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2843 SW MILL CREEK WAY",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349903196",
            "telephone_number": "318-547-2456",
            "fax_number": "772-675-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2843 SW MILL CREEK WAY",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "34990",
            "telephone_number": "318-547-2456",
            "fax_number": "318-547-2456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8108 SE Coconut St",
            "address_purpose": "LOCATION",
            "city": "Hobe Sound",
            "state": "FL",
            "postal_code": "334554008",
            "country_code": "US",
            "telephone_number": "561-312-3940",
            "fax_number": "772-675-9100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-08",
        "last_updated": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": "0-17-7942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "XXX",
            "identifier": "1111",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.