Active NPI
Jackie Sekunda
- Behavior Technician
- Palm Coast, FL
National Provider Identifier
1962232140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 9 Blakemore Dr
Palm Coast, FL 32137-7336 - Phone
- (973) 713-8051
- NPI assigned
- Aug 3, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Behavior Technician | 106S00000X | FL | Primary |
Addresses
Primary practice location
9 Blakemore Dr
Palm Coast, FL 32137-7336
Mailing address
9 Blakemore Dr
Palm Coast, FL 32137-7336
Phone (973) 713-8051
Other practice location 1
8 Wildwood Ln
Palm Coast, FL 32137-3221
Phone (386) 227-6485
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 |
|---|---|---|---|
| First Coast Autism LLC | Behavior Technician | 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": "1722643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722643200000",
"number": "1962232140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 BLAKEMORE DR",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321377336",
"telephone_number": "973-713-8051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 BLAKEMORE DR",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321377336",
"telephone_number": "973-713-8051"
}
],
"practiceLocations": [
{
"address_1": "8 Wildwood Ln",
"address_purpose": "LOCATION",
"city": "Palm Coast",
"state": "FL",
"postal_code": "321373221",
"country_code": "US",
"telephone_number": "386-227-6485",
"fax_number": "866-247-1790",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SEKUNDA",
"first_name": "JACKIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-08-03",
"last_updated": "2024-08-03",
"certification_date": "2024-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Coast, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.