Active NPI
Jacob Beduna
- Behavior Analyst
- Bloomington, IN
National Provider Identifier
1912446451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-16-22847
- Practice address
- 500 S Morton St
Suite 010
Bloomington, IN 47403-2460 - Phone
- (812) 322-0313
- Fax
- (812) 610-1814
- NPI assigned
- Feb 16, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-16-22847 | IN | Primary |
Addresses
Primary practice location
500 S Morton St
Suite 010
Bloomington, IN 47403-2460
Mailing address
9900 Gilmore Ridge Rd
Nashville, IN 47448-9731
Phone (812) 322-0313
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Supportive Community Innovations | Behavior Analyst | 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.
-
- Behavior Analyst
- Nashville, IN
- NPI 1902265267
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487203200000",
"number": "1912446451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9900 GILMORE RIDGE RD",
"city": "NASHVILLE",
"state": "IN",
"postal_code": "474489731",
"telephone_number": "812-322-0313",
"fax_number": "812-610-1814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 S MORTON ST",
"address_2": "SUITE 010",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474032460",
"telephone_number": "812-322-0313",
"fax_number": "812-610-1814"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEDUNA",
"first_name": "JACOB",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-02-16",
"last_updated": "2017-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IN",
"license": "1-16-22847",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.