Individual provider Active NPI

Jenna Laine Boggs

  • Behavior Technician
  • Jonesboro, AR
National Provider Identifier
1962316554
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1102 Laurelwood CT
Jonesboro, AR 72401-5128
Phone
(870) 243-6180
Fax
(479) 270-1291
NPI assigned
Sep 30, 2026
Last updated
Sep 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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 AR Primary

Addresses

Primary practice location

1102 Laurelwood CT
Jonesboro, AR 72401-5128

Mailing address

1102 Laurelwood CT
Jonesboro, AR 72401-5128
Phone (870) 243-6180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1962316554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 LAURELWOOD CT",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015128",
            "telephone_number": "870-243-6180",
            "fax_number": "479-270-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 LAURELWOOD CT",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015128",
            "telephone_number": "870-243-6180",
            "fax_number": "479-270-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGS",
        "first_name": "JENNA",
        "middle_name": "LAINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-30",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.