NPIMap

Organization Active NPI

Development Academy Corporation

Doing business as The Sergeant's Fish & Donut

  • Peer Specialist
  • Louisville, KY
National Provider Identifier
1154193563
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Legal business name
DEVELOPMENT ACADEMY CORPORATION
Doing business as
The Sergeant's Fish & Donut
Practice address
537 Dr W J Hodge St
Louisville, KY 40203-1561
Phone
(502) 802-3070
NPI assigned
Oct 27, 2023
Last updated
Oct 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Authorized official

Name
Gerail Pickett, B.S.
Title
Advisor
Phone
(502) 802-3070

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Community Health Worker 172V00000X NU
Community/Behavioral Health Agency 251S00000X NU
Peer Specialist 175T00000X NU Primary

Addresses

Primary practice location

537 Dr W J Hodge St
Louisville, KY 40203-1561

Mailing address

2414 Arthur St
Jeffersonville, IN 47130-9577
Phone (502) 910-1117

Other names 1

  • THE SERGEANT'S FISH & DONUT Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Development Academy Corporation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1698364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698364800000",
    "number": "1154193563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2414 ARTHUR ST",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471309577",
            "telephone_number": "502-910-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 DR W J HODGE ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402031561",
            "telephone_number": "502-802-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENT ACADEMY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-27",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A",
        "authorized_official_last_name": "PICKETT",
        "authorized_official_first_name": "GERAIL",
        "authorized_official_title_or_position": "ADVISOR",
        "authorized_official_telephone_number": "502-802-3070",
        "authorized_official_credential": "B.S."
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE SERGEANT'S FISH & DONUT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; 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.