Individual provider Active NPI

Brandy Donovan

  • Behavior Analyst
  • Lutz, FL
National Provider Identifier
1073963591
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
17815 Hunting Bow Cir
Lutz, FL 33558-5401
Phone
(813) 491-4425
NPI assigned
Jun 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

17815 Hunting Bow Cir
Lutz, FL 33558-5401

Mailing address

300 International Pkwy Ste 200
Lake Mary, FL 32746-5028
Phone (407) 915-7729

Other practice location 1

1140 Kyle Wood Ln
Brandon, FL 33511-4850
Phone (813) 548-1009 ext. 1

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

NPI Registry JSON

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1073963591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 INTERNATIONAL PKWY STE 200",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465028",
            "telephone_number": "407-915-7729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17815 HUNTING BOW CIR",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335585401",
            "telephone_number": "813-491-4425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1140 Kyle Wood Ln",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335114850",
            "country_code": "US",
            "telephone_number": "813-548-1009 x1",
            "fax_number": "813-708-5519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "BRANDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-15",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.