Active NPI
Brittany Nystrom
- Behavior Analyst
- Fort Walton Beach, FL
National Provider Identifier
1144904640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-26-88194
- Practice address
- 103 Rickey Ave
Fort Walton Beach, FL 32547-2520 - Phone
- (850) 376-5624
- NPI assigned
- Jun 14, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-26-88194 | FL | Primary |
Addresses
Primary practice location
103 Rickey Ave
Fort Walton Beach, FL 32547-2520
Mailing address
103 Rickey Ave
Fort Walton Beach, FL 32547-2520
Phone (850) 376-5624
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": "1686700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772755200000",
"number": "1144904640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 RICKEY AVE",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325472520",
"telephone_number": "850-376-5624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 RICKEY AVE",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325472520",
"telephone_number": "850-376-5624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NYSTROM",
"first_name": "BRITTANY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-14",
"last_updated": "2026-03-06",
"certification_date": "2026-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "1-26-88194",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Walton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.