Jaded Lotus Academy

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

JADED LOTUS ACADEMY

Practice address

5115 Covington Way Ste 5
Memphis, TN 38134-5619

Phone

(901) 498-0108

Fax

(901) 910-3399

NPI assigned

Feb 27, 2023

Organization subpart

No

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

Authorized official

Name

Ms. Jojuan Fullwiley, BCBANPI 1417469628

Title

Owner

Phone

(901) 498-0108

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jojuan Fullwiley, BCBA

  • Behavior Analyst
  • Memphis, TN
  • NPI 1417469628
  NPD Authorized official

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677456000000",
    "number": "1740989896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 COVINGTON WAY STE 5",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381345619",
            "telephone_number": "901-498-0108",
            "fax_number": "901-910-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 COVINGTON WAY STE 5",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381345619",
            "telephone_number": "901-498-0108",
            "fax_number": "901-910-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JADED LOTUS ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A",
        "authorized_official_last_name": "FULLWILEY",
        "authorized_official_first_name": "JOJUAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-498-0108",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer L. Jacobson, PSY.D.
• George Jacoby, M.A. SLPE
• Lisa M Jacola, PH.D.
• Jacqueline London (5 Star Transit)
• Jaded Lotus ABA LLC
• Frederick John Jaecklein, M.D.
• Jaeco Staffing (Jaeco Homehealth)
• Robin Jaffe, LADAC
• Bhuvaneshwari Jagadesan, M.D.
• Aakriti Jain

• Behavior Analyst in Memphis, TN
• Providers in Memphis, TN by specialty
• Behavior Analyst in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.