Jacob Samuel Nelson, BHT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

15214 N Cave Creek Rd Ste a
Phoenix, AZ 85032-4360

Phone

(888) 973-2090

NPI assigned

Oct 18, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jacob Nelson Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Guardian Angel Family Services

  • Behavior Technician
  • Phoenix, AZ
  • NPI 1205529633
  NPD Authorized official

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1871256842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5707 N 44TH LN STE B",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853016307",
            "telephone_number": "800-501-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15214 N CAVE CREEK RD STE A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850324360",
            "telephone_number": "888-973-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JACOB",
        "middle_name": "SAMUEL",
        "credential": "BHT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-18",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://email.gafsaz.com/",
            "affiliation": "N",
            "endpointDescription": "Domain email portal",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "15214 N Cave Creek Rd Ste A",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850324360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACOB",
            "last_name": "NELSON",
            "credential": "BHT II",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Elsie Ann Nelson
• Emily Nelson, MA, LAC
• Emily Anne Nelson
• Frederick Nelson
• Holley Nelson
• Jean Elizabeth Nelson
• Jean Lee Nelson, D.O.
• Jennifer Nelson, D.O.
• Jennifer Nelson, PA
• Jessica Amy Nelson

• Behavior Technician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Behavior Technician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.