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Kimberly Nicole Jackson , LBA

Behavior Analyst β€’ Abingdon, VA

Active NPI 1104480615 Individual Practitioner Female Practitioner
Practice location in NPPES

27018 Lee Hwy
Abingdon, VA 242117512

Call 2765254460 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

27018 Lee Hwy

Abingdon, VA 242117512

Telephone 2765254460
Other Listings in Public Data

NPPES lists 1 additional practice-address record in Wytheville, VA. 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

2019

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 Abingdon and Virginia

7 active clinicians are listed under Behavior Analyst with a practice address in Abingdon, VA (2,776 in Virginia).

Addresses are self-reported to NPPES and may be out of date.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: 2020-11-17
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

License # reported to NPPES VA 0133001314

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: Virginia Department of Health Professions.
Look Up on State Board Site

Secondary Practice Locations

540 W Main St

Wytheville, VA 243822209

Phone: 2762233291

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
Michael Keohane , LCSW

Social Worker - Clinical

NPI 1861535254

Licensed Clinical Social Worker

Career & Practice History Timeline

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

8 Historical Events
πŸ“
Updated Practice Location November 17, 2020

Registered at 27018 LEE HWY, ABINGDON, VA 242117512 (Tel: 2765254460)

πŸ“
Updated Business Mailing Address November 17, 2020

Registered at 27018 LEE HWY, ABINGDON, VA 242117512 (Tel: 2765254460)

βœ…
NPI Profile Active April 30, 2019

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 30, 2019

Registered at 540 W MAIN ST, WYTHEVILLE, VA 243822209 (Tel: 2762233291)

πŸ“
Business Mailing Address (Initial Record) April 30, 2019

Registered at 770 W RIDGE RD, WYTHEVILLE, VA 243821187 (Tel: 2762233200)

πŸ‘€
Provider Name / Credentials (Initial Record) April 30, 2019

Recorded as KIMBERLY JACKSON, LBA

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 30, 2019

Behavior Analyst (license number reported to NPPES: VA 0133001314)

🟒
Initial NPI Registration & Enumeration April 30, 2019

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1104480615
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 30, 2019
Last Update: November 17, 2020
Sole Proprietor: No

Mailing Address

27018 Lee Hwy

Abingdon, VA 242117512

Phone: 2765254460

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.