Individual provider Active NPI

Jamie Lee Klunk

  • Behavior Technician
  • Lake Mary, FL
National Provider Identifier
1750088340
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
3415 W Lake Mary Blvd # 4045
Lake Mary, FL 32795-7501
Phone
(407) 995-6106
NPI assigned
Feb 14, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

3415 W Lake Mary Blvd # 4045
Lake Mary, FL 32795-7501

Mailing address

715 Oakland Rd
Altamonte Springs, FL 32701-6855
Phone (863) 280-4123

Other identifiers 1

IdentifierTypeStateIssuer
VFM222925OtherFLFLORIDA HEALTH CARE PLAN

Other names 1

  • Miss Jamie Lee Knight Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1750088340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 OAKLAND RD",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327016855",
            "telephone_number": "863-280-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 W LAKE MARY BLVD # 4045",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327957501",
            "telephone_number": "407-995-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUNK",
        "first_name": "JAMIE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-14",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA HEALTH CARE PLAN",
            "identifier": "VFM222925",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "KNIGHT",
            "middle_name": "LEE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.