Jeffrey Patrick Jerviss

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-24-73620 Issued in FL

Practice address

2615 Fairways Dr
Homestead, FL 33035-1173

Phone

(786) 224-4525

NPI assigned

Nov 18, 2020

Last updated

Dec 2, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

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  NPD Authorized official

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1720681273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3460 BANKS RD APT 203",
            "city": "MARGATE",
            "state": "FL",
            "postal_code": "330636945",
            "telephone_number": "954-204-8250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 FAIRWAYS DR",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330351173",
            "telephone_number": "786-224-4525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18490 Johnson St Unit Efgh",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330293699",
            "country_code": "US",
            "telephone_number": "754-200-1031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JERVISS",
        "first_name": "JEFFREY",
        "middle_name": "PATRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-18",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-24-73620",
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": "0-2314716",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-20-145104",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Homestead, FL
• Providers in Homestead, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.