Individual provider Active NPI

Luis Josue Nevarez

  • Behavior Analyst
  • Thornton, CO
National Provider Identifier
1881231884
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-22-58539 Issued in CO
Practice address
550 Thornton Pkwy Unit 234
Thornton, CO 80229-2167
Phone
(720) 459-7493
Fax
(720) 583-2382
NPI assigned
Dec 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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-19-104642 CA
Behavior Analyst 103K00000X 1-22-58539 CO Primary

Addresses

Primary practice location

550 Thornton Pkwy Unit 234
Thornton, CO 80229-2167

Mailing address

550 Thornton Pkwy Unit 234
Thornton, CO 80229-2167
Phone (720) 459-7493

Other practice location 1

251 Airport Rd
Oceanside, CA 92058-1201
Phone (760) 721-1706

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-19-104642CAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Holista, LLC 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": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1881231884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 THORNTON PKWY UNIT 234",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802292167",
            "telephone_number": "720-459-7493",
            "fax_number": "720-583-2382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 THORNTON PKWY UNIT 234",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802292167",
            "telephone_number": "720-459-7493",
            "fax_number": "720-583-2382"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "251 Airport Rd",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "CA",
            "postal_code": "920581201",
            "country_code": "US",
            "telephone_number": "760-721-1706",
            "fax_number": "760-231-5574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEVAREZ",
        "first_name": "LUIS",
        "middle_name": "JOSUE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-09",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "RBT-19-104642",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CO",
            "license": "1-22-58539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; 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.