Individual provider Active NPI

Tillman R Ricketson, BCABA

  • Assistant Behavior Analyst
  • Columbus, OH
National Provider Identifier
1770815441
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
0-07-2340 Issued in OH
Practice address
5033 Sullivant Ave
Columbus, OH 43228-1749
Phone
(855) 832-6727
NPI assigned
Feb 5, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X 0-07-2340 OH Primary
Behavior Analyst 103K00000X 0-07-2340 FL

Addresses

Primary practice location

5033 Sullivant Ave
Columbus, OH 43228-1749

Mailing address

2987 Bayshore Dr
Tallahassee, FL 32309-2251
Phone (850) 980-6863

Other practice location 1

1406 Hays St
Tallahassee, FL 32301-2833
Phone (850) 521-0242

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": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1770815441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2987 BAYSHORE DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323092251",
            "telephone_number": "850-980-6863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5033 SULLIVANT AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281749",
            "telephone_number": "855-832-6727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1406 Hays St",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323012833",
            "country_code": "US",
            "telephone_number": "850-521-0242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICKETSON",
        "first_name": "TILLMAN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "BCABA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-05",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "OH",
            "license": "0-07-2340",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "0-07-2340",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; 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.