Individual provider Active NPI

Ja'Miyah Sturdivant

  • Behavior Analyst
  • Kernersville, NC
National Provider Identifier
1801555693
Registry record updated Apr 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
2438 Issued in NC
Practice address
418 W Mountain St Ste B
Kernersville, NC 27284-2534
Phone
(801) 935-4171
NPI assigned
Dec 9, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Behavior Analyst 103K00000X 2438 NC Primary

Addresses

Primary practice location

418 W Mountain St Ste B
Kernersville, NC 27284-2534

Mailing address

PO Box 8544
Pasadena, CA 91109-8602

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": "1639008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743897600000",
    "number": "1801555693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8544",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911098602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 W MOUNTAIN ST STE B",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842534",
            "telephone_number": "801-935-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURDIVANT",
        "first_name": "JA'MIYAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-09",
        "last_updated": "2025-04-06",
        "certification_date": "2025-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "2438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.