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Jordyn M Johnson , BCBA

Behavior Analyst β€’ Glen Carbon, IL

Active NPI 1063907855 Individual Practitioner Female Practitioner
Practice location in NPPES

4559 Benes Ave
Glen Carbon, IL 62034

Call 2175258332 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

4559 Benes Ave

Glen Carbon, IL 62034

Telephone 2175258332
Fax 2177891420
Organization at the Same NPPES Address or Phone
Hope Clinical Care Facility NPI 1437686870

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 5 distinct additional practice-address records in Edwardsville, IL; Herrin, IL; O Fallon, IL and 1 more. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2018

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Glen Carbon and Illinois

5 active clinicians are listed under Behavior Analyst with a practice address in Glen Carbon, IL (3,085 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-01-06
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.
Look Up on State Board Site

Secondary Practice Locations

2315 N Park Ave

Herrin, IL 629483046

Phone: 2175258332

3022 S Park Ave Ste B

Herrin, IL 629483721

Phone: 2175258332

145 Springfield Ct

O Fallon, IL 622692495

Phone: 2175258332

5220 6th Street Frontage Rd E Ste 1700

Springfield, IL 627035771

Phone: 2175258332

115 Rottingham Ct Ste A

Edwardsville, IL 620253677

Phone: 8665222467

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸ“
Updated Practice Location January 09, 2023

Registered at 4559 BENES AVE, GLEN CARBON, IL 62034 (Tel: 2175258332)

πŸ‘€
Provider Name / Credentials Updated January 09, 2023

Recorded as JORDYN JOHNSON, BCBA

πŸ‘€
Provider Name / Credentials Updated January 22, 2021

Recorded as JORDYN ROADY, BCBA

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 22, 2021

Behavior Analyst

βœ…
NPI Profile Active June 25, 2018

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) June 25, 2018

Registered at 115 ROTTINGHAM CT STE A, EDWARDSVILLE, IL 620253677 (Tel: 8665222467)

πŸ“
Business Mailing Address (Initial Record) June 25, 2018

Registered at 5220 6TH STREET FRONTAGE RD E STE 1700, SPRINGFIELD, IL 627035771 (Tel: 2175258332)

πŸ‘€
Provider Name / Credentials (Initial Record) June 25, 2018

Recorded as JORDYN ROADY, RBT

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 25, 2018

Behavior Technician

🟒
Initial NPI Registration & Enumeration June 25, 2018

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1063907855
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 25, 2018
Last Update: January 09, 2023
Sole Proprietor: No

Mailing Address

5220 6th Street Frontage Rd E Ste 1700

Springfield, IL 627035771

Phone: 2175258332

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.