Individual provider Active NPI

Chris Dakota Jenkins

  • Behavior Technician
  • Rock Springs, WY
National Provider Identifier
1831857432
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-21-194863 Issued in WY
Practice address
2632 Foothill Blvd
Rock Springs, WY 82901-4756
Phone
(307) 212-3284
NPI assigned
Dec 1, 2021
Last updated
Dec 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-21-194863 WY Primary

Addresses

Primary practice location

2632 Foothill Blvd
Rock Springs, WY 82901-4756

Mailing address

310 E Broadway Ave
Jackson, WY 83001-8636
Phone (307) 212-3284

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.pkservice.org

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

LicenseStateTypeSpecialty
RBT-21-194863WYMDBehavior Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1831857432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E BROADWAY AVE",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018636",
            "telephone_number": "307-212-3284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2632 FOOTHILL BLVD",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829014756",
            "telephone_number": "307-212-3284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "CHRIS",
        "middle_name": "DAKOTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-01",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WY",
            "license": "RBT-21-194863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.pkservice.org",
            "affiliation": "N",
            "address_1": "2632 Foothill Blvd",
            "city": "Rock Springs",
            "state": "WY",
            "country_code": "US",
            "postal_code": "829014756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rock Springs, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.