Gavin Payne Wolfe

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

103B Lewis St
Fort Walton Beach, FL 32547-3142

Phone

(850) 362-6824

Fax

(850) 362-6826

NPI assigned

Dec 31, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1514678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514678400000",
    "number": "1073020913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103B LEWIS ST",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325473142",
            "telephone_number": "850-362-6824",
            "fax_number": "850-362-6826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103B LEWIS ST",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325473142",
            "telephone_number": "850-362-6824",
            "fax_number": "850-362-6826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "GAVIN",
        "middle_name": "PAYNE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-31",
        "last_updated": "2017-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Wise, L.M.H.C.
• Jessica Wise, M.D.
• Sharon Renee Wise, LMHC
• Matthew Wisniewski, PTA
• Andrea J Witt, CRNA
• Tade L Wolfe, MA, CCC-SLP
• Vicky Wolfe, PHD
• Megan Wolter, BCBA
• Carolyn V Woo, RPH
• Jean Woo, D.D.S.

• Behavior Technician in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2017; 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.