Active NPI
Chance D Gorman
- Behavior Analyst
- Melbourne, FL
National Provider Identifier
1174245708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 5240 Babcock St. NE
Suite 105
Melbourne, FL 32905 - Phone
- (321) 837-3746
- Fax
- (321) 428-8924
- NPI assigned
- Sep 12, 2022
- Sex
- Male
- Sole proprietor
- No
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 | FL | Primary |
Addresses
Primary practice location
5240 Babcock St. NE
Suite 105
Melbourne, FL 32905
Mailing address
1151 Nordic St. NW
Palm Bay, FL 32907
Phone (321) 722-7292
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": "1662940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662940800000",
"number": "1174245708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1151 NORDIC ST. NW",
"city": "PALM BAY",
"state": "FL",
"postal_code": "32907",
"telephone_number": "321-722-7292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5240 BABCOCK ST. NE",
"address_2": "SUITE 105",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "32905",
"telephone_number": "321-837-3746",
"fax_number": "321-428-8924"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORMAN",
"first_name": "CHANCE",
"middle_name": "D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-12",
"last_updated": "2022-09-12",
"certification_date": "2022-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.