Individual provider Active NPI

Jessica Leann Wright, RBT

  • Behavior Technician
  • Clarksville, TN
National Provider Identifier
1881160679
Registry record updated Sep 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-20-136149 Issued in TN
Practice address
3441 Fort Campbell Blvd Ste F3
Clarksville, TN 37042-6684
Phone
(931) 449-0063
Fax
(931) 896-2737
NPI assigned
Oct 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2020

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 RBT-20-136149 TN Primary
Behavior Technician 106S00000X RBT-18-67104 TN

Addresses

Primary practice location

3441 Fort Campbell Blvd Ste F3
Clarksville, TN 37042-6684

Mailing address

3441 Fort Campbell Blvd Ste F3
Clarksville, TN 37042-6684
Phone (931) 449-0063

Other identifiers 1

IdentifierTypeStateIssuer
RBT-20-136149OtherTNBACB

Other names 1

  • Jessica Leann Baxter Former name

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-18-67104TNMDBehavior Technician
RBT-20-136149TNMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Behavior Consultants Behavior Technician Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600560000000",
    "number": "1881160679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3441 FORT CAMPBELL BLVD STE F3",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370426684",
            "telephone_number": "931-449-0063",
            "fax_number": "931-896-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3441 FORT CAMPBELL BLVD STE F3",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370426684",
            "telephone_number": "931-449-0063",
            "fax_number": "931-896-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "JESSICA",
        "middle_name": "LEANN",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-18",
        "last_updated": "2020-09-20",
        "certification_date": "2020-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TN",
            "license": "RBT-20-136149",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TN",
            "license": "RBT-18-67104",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BACB",
            "identifier": "RBT-20-136149",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BAXTER",
            "middle_name": "LEANN",
            "credential": "RBT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2020; 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.