NPIMap

Organization Active NPI

Spectrum House Inc.

  • Behavior Analyst
  • Milton, FL
National Provider Identifier
1124753330
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
SPECTRUM HOUSE INC.
Practice address
6479 Caroline St
Milton, FL 32570-4502
Phone
(850) 607-6910
NPI assigned
Jul 21, 2022
Organization subpart
Yes
Parent organization
SPECTRUM HOUSE INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Tyler Russell Steverson
Title
Credentialing Manager
Phone
(850) 607-6910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

6479 Caroline St
Milton, FL 32570-4502

Mailing address

9900 N Davis Hwy
Pensacola, FL 32514-8124

National Provider Directory

National Provider Directory
Tax ID family
Spectrum House Inc8 organizations share this tax ID, including this one
Part of
Spectrum House Inc

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6479 Caroline St
Milton, FL 32570
Phone (850) 324-0633

9900 N Davis Hwy
Pensacola, FL 32514
Phone (251) 978-4767

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1124753330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325148124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6479 CAROLINE ST",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325704502",
            "telephone_number": "850-607-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HOUSE INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM HOUSE INC.",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-11",
        "status": "A",
        "authorized_official_last_name": "STEVERSON",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "850-607-6910"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.