Individual provider Active NPI

Andrew Millerwise

  • Behavior Analyst
  • Tampa, FL
National Provider Identifier
1225327943
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-11-8928 Issued in NU
Practice address
6951 Pistol Range Rd
Suite 101
Tampa, FL 33635-9601
Phone
(813) 814-2000
NPI assigned
Apr 4, 2011
Last updated
Mar 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-11-8928 NU Primary
Developmental Therapist 222Q00000X NU

Addresses

Primary practice location

6951 Pistol Range Rd
Suite 101
Tampa, FL 33635-9601

Mailing address

4221 10TH Ave N
St Petersburg, FL 33713-5935
Phone (269) 998-0704

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": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1225327943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 10TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337135935",
            "telephone_number": "269-998-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6951 PISTOL RANGE RD",
            "address_2": "SUITE 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336359601",
            "telephone_number": "813-814-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLERWISE",
        "first_name": "ANDREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-04",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": "1-11-8928",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.