Individual provider Active NPI

Isaac Donald Bosse Sr., B.S

  • Behavior Analyst
  • Kissimmee, FL
National Provider Identifier
1235537945
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
59-3595260 Issued in FL
Practice address
4115 Wellington Woods Cir
Kissimmee, FL 34741-2750
Phone
(407) 483-8369
NPI assigned
Dec 11, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 59-3595260 FL Primary

Addresses

Primary practice location

4115 Wellington Woods Cir
Kissimmee, FL 34741-2750

Mailing address

4115 Wellington Woods Cir
Kissimmee, FL 34741-2750
Phone (407) 483-8369

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
59-3595260FLMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1235537945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 WELLINGTON WOODS CIR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412750",
            "telephone_number": "407-483-8369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 WELLINGTON WOODS CIR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412750",
            "telephone_number": "407-483-8369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSSE",
        "first_name": "ISAAC",
        "middle_name": "DONALD",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "B.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-11",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "59-3595260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; 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.