Active NPI
Tracey Schultz, BCBA
- Behavior Analyst
- Santa Rosa Beach, FL
National Provider Identifier
1053152991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 12473101
- Practice address
- 305 Mack Bayou Rd
Santa Rosa Beach, FL 32459-7199 - Phone
- (850) 213-4595
- NPI assigned
- Jun 4, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 12473101 | FL | Primary |
Addresses
Primary practice location
305 Mack Bayou Rd
Santa Rosa Beach, FL 32459-7199
Mailing address
320 Cicero St
Panama City Beach, FL 32407-3353
Phone (262) 719-6938
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12473101 | FL | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Walton Academy, Inc. | Behavior Analyst | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717459200000",
"number": "1053152991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 CICERO ST",
"city": "PANAMA CITY BEACH",
"state": "FL",
"postal_code": "324073353",
"telephone_number": "262-719-6938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 MACK BAYOU RD",
"city": "SANTA ROSA BEACH",
"state": "FL",
"postal_code": "324597199",
"telephone_number": "850-213-4595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHULTZ",
"first_name": "TRACEY",
"credential": "BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-04",
"last_updated": "2024-06-04",
"certification_date": "2024-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "12473101",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.