Individual provider Active NPI

Jordyn Paige Niederhiser, M.S., BCBA

  • Behavior Analyst
  • Jacksonville, FL
National Provider Identifier
1912450446
Registry record updated Mar 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-18-32840
Practice address
4800 Deerwood Campus Pkwy
Jacksonville, FL 32246-8317
Phone
(877) 887-1797
NPI assigned
Aug 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-18-32840 Primary

Addresses

Primary practice location

4800 Deerwood Campus Pkwy
Jacksonville, FL 32246-8317

Mailing address

PO Box 6729
Leawood, KS 66206-0729

Other names 1

  • Jordyn Paige Elliott 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
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709424000000",
    "number": "1912450446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6729",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662060729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 DEERWOOD CAMPUS PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322468317",
            "telephone_number": "877-887-1797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEDERHISER",
        "first_name": "JORDYN",
        "middle_name": "PAIGE",
        "credential": "M.S., BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2024-03-03",
        "certification_date": "2024-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-18-32840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDYN",
            "last_name": "ELLIOTT",
            "middle_name": "PAIGE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2024; 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.