Gulf Coast Autism Clinic, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

GULF COAST AUTISM CLINIC, LLC

Practice address

2404 Ruth Hentz Ave BLDG B
Panama City, FL 32405-2258

Phone

(850) 628-7572

NPI assigned

Oct 28, 2020

Organization subpart

No

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

Authorized official

Name

Kuryn Patterson, BCBA

Title

Ceo

Phone

(850) 628-7572

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kuryn Wheeler, BCBA

  • Behavior Analyst
  • Panama City, FL
  • NPI 1689087751
  NPD

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1013517143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 RUTH HENTZ AVE BLDG B",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324052258",
            "telephone_number": "850-628-7572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 RUTH HENTZ AVE BLDG B",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324052258",
            "telephone_number": "850-628-7572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST AUTISM CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-28",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "KURYN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-628-7572",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Gruber
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• Gulf Coast Hearing Centers, Inc.

• Behavior Analyst in Panama City, FL
• Providers in Panama City, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.