NPIMap

Organization Active NPI

Community Development Center

Doing business as Child Development Center

  • Behavior Analyst
  • Lewisburg, TN
National Provider Identifier
1891145678
Registry record updated Nov 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
COMMUNITY DEVELOPMENT CENTER
Doing business as
Child Development Center
Practice address
1600 Jason Maxwell Blvd
Lewisburg, TN 37091-2018
Phone
(931) 359-1197
NPI assigned
Jun 13, 2016
Last updated
Nov 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2017

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

Authorized official

Name
Mr. Robert Jacobi
Title
Business Manager
Phone
(931) 684-8681

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary
In Home Supportive Care Agency 253Z00000X
Behavior Technician 106S00000X

Addresses

Primary practice location

1600 Jason Maxwell Blvd
Lewisburg, TN 37091-2018

Mailing address

113 Eaglette Way
Shelbyville, TN 37160-9263
Phone (931) 684-8681

Other names 1

  • Child Development Center Doing business as

National Provider Directory

National Provider Directory

Locations

1000 Washington St W
Ste C
Fayetteville, TN 37334
Phone (931) 684-9203

1600 Jason Maxwell Blvd
Lewisburg, TN 37091
Phone (931) 359-1197

111 Eaglette Way
Shelbyville, TN 37160
Phone (931) 684-9203

113 Eaglette Way
Shelbyville, TN 37160
Phone (931) 684-8681

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509926400000",
    "number": "1891145678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 EAGLETTE WAY",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371609263",
            "telephone_number": "931-684-8681",
            "fax_number": "931-684-9431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 JASON MAXWELL BLVD",
            "city": "LEWISBURG",
            "state": "TN",
            "postal_code": "370912018",
            "telephone_number": "931-359-1197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY DEVELOPMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-13",
        "last_updated": "2017-11-06",
        "status": "A",
        "authorized_official_last_name": "JACOBI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "931-684-8681",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Child Development Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lewisburg, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2017; 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.