NPIMap

Organization Active NPI

Pediatric Therapies of Northwest Florida, LLC

  • Community/Behavioral Health Agency
  • Pensacola, FL
National Provider Identifier
1073913893
Registry record updated Aug 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PEDIATRIC THERAPIES OF NORTHWEST FLORIDA, LLC
Practice address
7840 Lilac LN
Apt 508
Pensacola, FL 32514-7668
Phone
(850) 260-9016
Fax
(850) 912-8561
NPI assigned
Aug 28, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2014

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

Authorized official

Name
Mr. Tyler Russell Steverson
Title
Owner
Phone
(850) 260-9016

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

7840 Lilac LN
Apt 508
Pensacola, FL 32514-7668

Mailing address

7840 Lilac LN
Apt 508
Pensacola, FL 32514-7668
Phone (850) 260-9016

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409184000000",
    "number": "1073913893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7840 LILAC LN",
            "address_2": "APT 508",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325147668",
            "telephone_number": "850-260-9016",
            "fax_number": "850-912-8561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7840 LILAC LN",
            "address_2": "APT 508",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325147668",
            "telephone_number": "850-260-9016",
            "fax_number": "850-912-8561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC THERAPIES OF NORTHWEST FLORIDA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-28",
        "last_updated": "2014-08-28",
        "status": "A",
        "authorized_official_last_name": "STEVERSON",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-260-9016",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2014; 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.