Organization Active NPI

Connection Behavioral Health

  • Psychiatric/Mental Health Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1033736418
Registry record updated Feb 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
CONNECTION BEHAVIORAL HEALTH
Practice address
9800 4TH St N Ste 200
St Petersburg, FL 33702-2462
Phone
(727) 251-5470
NPI assigned
Jul 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2022

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

Authorized official

Name
Patrick Desir, APRNNPI 1700401650
Title
Pmhnp-BC
Phone
(727) 201-5470

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

9800 4TH St N Ste 200
St Petersburg, FL 33702-2462

Mailing address

9800 4TH St N Ste 200
St Petersburg, FL 33702-2462
Phone (727) 201-5470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200921002247 FL Part B Supplier - Clinic/Group Practice 1254759459 Receives reassigned benefits from 2 practitioners
Practice locations: Saint Petersburg, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645920000000",
    "number": "1033736418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9800 4TH ST N STE 200",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337022462",
            "telephone_number": "727-201-5470",
            "fax_number": "727-914-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 4TH ST N STE 200",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337022462",
            "telephone_number": "727-251-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTION BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-01",
        "last_updated": "2022-02-27",
        "certification_date": "2022-02-27",
        "status": "A",
        "authorized_official_last_name": "DESIR",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "PMHNP-BC",
        "authorized_official_telephone_number": "727-201-5470",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.