Jalen Billingsley

Key facts

NPI

1801637137

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Technician 106S00000X

License

-24-355017 (GA)

Practice address

1400 Stateboro Place Cir
Building S Appt 199
Statesboro, GA 30458

Phone

(229) 425-0286

NPI assigned

Jun 3, 2024

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2024.

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1801637137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 STATEBORO PLACE CIR",
            "address_2": "BUILDING S APPT 199",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "229-425-0286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 STATEBORO PLACE CIR",
            "address_2": "BUILDING S APPT 199",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "229-425-0286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILLINGSLEY",
        "first_name": "JALEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "-24-355017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

• Robert Moore Benson Jr., MD
• Zackary L. Bentley, D.M.D.
• Brant Douglas Berkstresser, ATC
• Harsh Bhushan, M.D.
• Big Step Solutions Inc
• Brianna K Billups, BS
• Rachel Lauren Binkley, RD
• Bio-Medical Applications of Georgia, Inc.
• Marc E Bisseck, M.D.
• Blackbird and Cornerstone LLC

All providers in Statesboro, GA · Behavior Technician in Georgia