Jessica Dawn Stefek

Key facts

NPI

1740964964

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Technician 106S00000X

Practice address

900 N Park St
Ellsworth, KS 67439-1834

Phone

(785) 810-8433

NPI assigned

Jun 9, 2023

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 9, 2023.

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1740964964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N PARK ST",
            "city": "ELLSWORTH",
            "state": "KS",
            "postal_code": "674391834",
            "telephone_number": "785-810-8433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N PARK ST",
            "city": "ELLSWORTH",
            "state": "KS",
            "postal_code": "674391834",
            "telephone_number": "785-810-8433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFEK",
        "first_name": "JESSICA",
        "middle_name": "DAWN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-09",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Ellsworth, KS · Behavior Technician in Kansas