Individual provider Active NPI

Jordan Leigh Hoeppel

  • Behavior Technician
  • Kennesaw, GA
National Provider Identifier
1912638289
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-22-220801 Issued in GA
Practice address
3330 Chastain Meadows Pkwy NW Ste 200
Kennesaw, GA 30144-5881
Phone
(678) 648-7644
Fax
(678) 648-7479
NPI assigned
Jun 18, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-22-220801 GA Primary

Addresses

Primary practice location

3330 Chastain Meadows Pkwy NW Ste 200
Kennesaw, GA 30144-5881

Mailing address

1072 Powell Wright Rd
Marietta, GA 30066-6463
Phone (706) 513-1226

Other practice location 1

5163 Roswell Rd # Ed
Sandy Springs, GA 30342-2206
Phone (877) 288-4760

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-22-220801GAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Dogwood Autism Services, LLC CurrentSince Jun 1, 2022 Accepting new patients
Therapyland LLC PastSince May 14, 2023 Accepting new patients

Locations

5163 Roswell Rd
Sandy Springs, GA 30342
Phone (678) 602-9523

Organizations & group practices 2

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": "1655510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1912638289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1072 POWELL WRIGHT RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666463",
            "telephone_number": "706-513-1226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 CHASTAIN MEADOWS PKWY NW STE 200",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301445881",
            "telephone_number": "678-648-7644",
            "fax_number": "678-648-7479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5163 Roswell Rd # Ed",
            "address_purpose": "LOCATION",
            "city": "Sandy Springs",
            "state": "GA",
            "postal_code": "303422206",
            "country_code": "US",
            "telephone_number": "877-288-4760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOEPPEL",
        "first_name": "JORDAN",
        "middle_name": "LEIGH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-18",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "RBT-22-220801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.