NPIMap

Organization Active NPI

Santa Rosa County School Board

  • School Psychologist
  • Milton, FL
National Provider Identifier
1013078104
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
Legal business name
SANTA ROSA COUNTY SCHOOL BOARD
Practice address
6751 Berryhill St
Milton, FL 32570-4790
Phone
(850) 983-5151
Fax
(850) 983-5577
NPI assigned
Dec 12, 2006
Last updated
Jan 29, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Roderick C. Gracey
Title
Director Student Services
Phone
(850) 983-5587

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X NU Primary

Addresses

Primary practice location

6751 Berryhill St
Milton, FL 32570-4790

Mailing address

6751 Berryhill St
Milton, FL 32570-4790
Phone (850) 983-5151

Other identifiers 1

IdentifierTypeStateIssuer
081005317MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Santa Rosa County School Board11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233187200000",
    "number": "1013078104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6751 BERRYHILL ST",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325704790",
            "telephone_number": "850-983-5151",
            "fax_number": "850-983-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6751 BERRYHILL ST",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325704790",
            "telephone_number": "850-983-5151",
            "fax_number": "850-983-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA ROSA COUNTY SCHOOL BOARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2009-01-29",
        "status": "A",
        "authorized_official_last_name": "GRACEY",
        "authorized_official_first_name": "RODERICK",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "DIRECTOR STUDENT SERVICES",
        "authorized_official_telephone_number": "850-983-5587",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081005317",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.