Active NPI
Jelisia Jemae Thompson
- Behavior Analyst
- Red Oak, TX
National Provider Identifier
1730754326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-21-49405
- Practice address
- 102 Brothers Blvd
Red Oak, TX 75154-6152 - Phone
- (469) 673-8867
- NPI assigned
- May 25, 2021
- Sex
- Female
- 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 | 1-21-49405 | TX | Primary |
Addresses
Primary practice location
102 Brothers Blvd
Red Oak, TX 75154-6152
Mailing address
833 Brockden Dr
Mesquite, TX 75149-3275
Phone (952) 393-7755
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Gifted Journey ( Behavioral, Consulting and Advocacy) | Behavior Analyst | Current | Accepting new patients |
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.
-
- Behavior Analyst
- Mesquite, TX
- NPI 1962182543
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621900800000",
"number": "1730754326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "833 BROCKDEN DR",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751493275",
"telephone_number": "952-393-7755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 BROTHERS BLVD",
"city": "RED OAK",
"state": "TX",
"postal_code": "751546152",
"telephone_number": "469-673-8867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "JELISIA",
"middle_name": "JEMAE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-25",
"last_updated": "2021-05-25",
"certification_date": "2021-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "1-21-49405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Red Oak, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.