Active NPI
Jeffery Sickler
- Behavior Technician
- Shenandoah, TX
National Provider Identifier
1922772524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-21-178501
- Practice address
- 19241 David Memorial Dr Ste 170a
Shenandoah, TX 77385-8786 - Phone
- (936) 321-8300
- NPI assigned
- Aug 6, 2021
- 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 Technician | 106S00000X | RBT-21-178501 | TX | Primary |
Addresses
Primary practice location
19241 David Memorial Dr Ste 170a
Shenandoah, TX 77385-8786
Mailing address
16835 Deer Creek Dr Ste 200
Spring, TX 77379-4895
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-21-178501 | TX | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cole Health, Inc. | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628208000000",
"number": "1922772524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16835 DEER CREEK DR STE 200",
"city": "SPRING",
"state": "TX",
"postal_code": "773794895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19241 DAVID MEMORIAL DR STE 170A",
"city": "SHENANDOAH",
"state": "TX",
"postal_code": "773858786",
"telephone_number": "936-321-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SICKLER",
"first_name": "JEFFERY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-08-06",
"last_updated": "2021-08-06",
"certification_date": "2021-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TX",
"license": "RBT-21-178501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shenandoah, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.