Johnathan Derrell Hamilton Sr., BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-20-44279 Issued in OK

Practice address

303 N Broadway St
Cleveland, OK 74020-3421

Phone

(539) 209-1209

Fax

(539) 203-3672

NPI assigned

Apr 10, 2018

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

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.

• Envision Therapies LLC

  • Behavior Analyst
  • Cleveland, OK
  • NPI 1790563963
  NPD

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1891292371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N BROADWAY ST",
            "city": "CLEVELAND",
            "state": "OK",
            "postal_code": "740203421",
            "telephone_number": "539-209-1209",
            "fax_number": "539-203-3673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N BROADWAY ST",
            "city": "CLEVELAND",
            "state": "OK",
            "postal_code": "740203421",
            "telephone_number": "539-209-1209",
            "fax_number": "539-203-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "JOHNATHAN",
        "middle_name": "DERRELL",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-10",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OK",
            "license": "1-20-44279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grand Lake Mental Health Center, Inc.
• Madison Bailee Green, LPC
• Annamarie Guinn
• Josue Gutierrez, DMD
• Ashley Nicole Hambright
• Kiseki Hamilton
• Lori Hamilton, PTA
• Natasha Nicole Hamilton, LCSW
• Crystal Hardway, M.S. CCC-SLP
• Britany Nichole Harris

• All providers in Cleveland, OK
• Behavior Analyst in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; 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.