Active NPI
Amanda Jondro
- Behavior Technician
- O Fallon, IL
National Provider Identifier
1770197667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 6 Eagle Ctr Ste 1
O Fallon, IL 62269-1945 - Phone
- (844) 854-1116
- NPI assigned
- Sep 8, 2020
- 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 | Primary |
Addresses
Primary practice location
6 Eagle Ctr Ste 1
O Fallon, IL 62269-1945
Mailing address
401 Garesche St
Collinsville, IL 62234-5324
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| J536-0169-7790 | Other | IL | DRIVERS LISCENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ajondro@acornhealth.com |
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": "1599523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599523200000",
"number": "1770197667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 GARESCHE ST",
"city": "COLLINSVILLE",
"state": "IL",
"postal_code": "622345324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 EAGLE CTR STE 1",
"city": "O FALLON",
"state": "IL",
"postal_code": "622691945",
"telephone_number": "844-854-1116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONDRO",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-08",
"last_updated": "2020-09-08",
"certification_date": "2020-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVERS LISCENSE",
"identifier": "J536-0169-7790",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ajondro@acornhealth.com",
"affiliation": "N",
"address_1": "6 Eagle Ctr Ste 1",
"city": "O Fallon",
"state": "IL",
"country_code": "US",
"postal_code": "622691945",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in O Fallon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.