NPIMap

Organization Active NPI

North Port BH, LLC

Doing business as North Port Behavioral Health

  • Psychiatric Hospital
  • North Port, FL
National Provider Identifier
1063258598
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
NORTH PORT BH, LLC
Doing business as
North Port Behavioral Health
Practice address
4501 Citizens Parkway
North Port, FL 34288
Phone
(914) 867-9470
NPI assigned
Jul 3, 2024
Last updated
Jan 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Authorized official

Name
Brian P. Farley
Title
Vice President and Secretary
Phone
(615) 861-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X Primary

Addresses

Primary practice location

4501 Citizens Parkway
North Port, FL 34288

Mailing address

4020 Aspen Grove Dr Ste 900
Franklin, TN 37067-3134
Phone (615) 861-6000

Other names 1

  • North Port Behavioral Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20241101003260 FL Part A Provider - Hospital 2961935622 Practice locations: North Port, FL
O20250313000482 FL Part B Supplier - Clinic/Group Practice 2961935622 Receives reassigned benefits from 13 practitioners
Practice locations: North Port, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063258598. Details of each certification follow.

Hospital certification: CCN 104087

Legal name
NORTH PORT BH LLC
Doing business as
NORTH PORT BEHAVIORAL HEALTH
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
May 25, 2025
Last certification
May 25, 2025
Beds
96
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Enrollment address
4501 Citizens Parkway
North Port, FL 34288-6000
Main/Primary Hospital Location
Hospital subgroups
Psychiatric

Care Compare: Hospital

Medicare Care Compare
Listed as
North Port Behavioral HealthCCN 104087 · All quality measures
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2315857North Port Behavioral Health4501 Citizens Parkway, North Port, FL 34288Certificate of waiverDec 19, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Deborah S Kraemer Individual W-2 Managing EmployeeVP of Business Office Operations Feb 9, 2022
Todd S Young Individual Corporate OfficerVice President & Treasurer Oct 27, 2025
Acadia Healthcare Company Inc Organization, Franklin, TN Corporation, For-profit, Chain home office 5% Or Greater Direct Ownership Interest Feb 9, 2022 100%
Stacie L Harty Individual W-2 Managing EmployeeVP of Managed Care Feb 9, 2022
Casey L Webb Individual W-2 Managing EmployeeFacility Ceo Jul 1, 2024
Brian Philip Farley Individual Corporate OfficerVice President, Secretary Jul 26, 2023
Timothy a Sides Individual W-2 Managing EmployeeSenior VP of Operations, Finance Jun 5, 2023
Debra K Osteen Individual Corporate OfficerPresident Jan 20, 2026

Facilities with the same owner 59

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 59

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767571200000",
    "number": "1063258598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 ASPEN GROVE DR STE 900",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370673134",
            "telephone_number": "615-861-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 CITIZENS PARKWAY",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "34288",
            "telephone_number": "914-867-9470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH PORT BH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-03",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A",
        "authorized_official_last_name": "FARLEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "VICE PRESIDENT AND SECRETARY",
        "authorized_official_telephone_number": "615-861-6000"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Port Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Port Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Port, FL

Sources for this page

Verify at the official NPI Registry.