Active NPI
Jennifer Tolbert
- Behavior Technician
- Dacula, GA
National Provider Identifier
1750906749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-19-76965
- Practice address
- 123 Dacula Road
Dacula, GA 30019-7912 - Phone
- (404) 583-5043
- NPI assigned
- Jun 15, 2020
- Last updated
- Nov 15, 2022
- Sex
- Female
- Sole proprietor
- No
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 Technician | 106S00000X | RBT-19-76965 | GA | Primary |
Addresses
Primary practice location
123 Dacula Road
Dacula, GA 30019-7912
Mailing address
PO Box 478
Dacula, GA 30019-7912
Phone (404) 583-5043
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750906749 | Medicaid | GA | |
| RBT-19-76965 | Other | GA | BEHAVIOR TECHNICIAN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-19-76965 | GA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668470400000",
"number": "1750906749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 478",
"city": "DACULA",
"state": "GA",
"postal_code": "300197912",
"telephone_number": "404-583-5043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 DACULA ROAD",
"city": "DACULA",
"state": "GA",
"postal_code": "300197912",
"telephone_number": "404-583-5043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOLBERT",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-15",
"last_updated": "2022-11-15",
"certification_date": "2021-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "RBT-19-76965",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1750906749",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEHAVIOR TECHNICIAN",
"identifier": "RBT-19-76965",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dacula, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.