Jamie Green

Key facts

NPI

1720873243

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Analyst 103K00000X

License

1-23-65069 (VA)

Practice address

90 Twelve Oaks Dr
Hardy, VA 24101-5633

Phone

(540) 287-2568

NPI assigned

Apr 14, 2025

Sex

Female

Sole proprietor

No

Organizations & group practices 1

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.

• Connect Behavioral Health LLC Behavior Analyst · Hardy, VA · NPI 1588038079
  NPD BEHAVIOR ANALYST

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 14, 2025.

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1720873243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 PARHAM DR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240145352",
            "telephone_number": "540-204-3544",
            "fax_number": "540-204-3544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 TWELVE OAKS DR",
            "city": "HARDY",
            "state": "VA",
            "postal_code": "241015633",
            "telephone_number": "540-287-2568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JAMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "1-23-65069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Hardy, VA · Behavior Analyst in Virginia