Organization Active NPI

Becky Durham-Flint, P.a.

  • Community/Behavioral Health Agency
  • Indialantic, FL
National Provider Identifier
1245552876
Registry record updated Feb 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
000389 Issued in FL
Legal business name
BECKY DURHAM-FLINT, P.A.
Practice address
105 S Riverside Dr
Suite 100
Indialantic, FL 32903-4365
Phone
(321) 733-2299
Fax
(321) 733-7515
NPI assigned
Feb 23, 2010
Last updated
Feb 23, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2010

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

Authorized official

Name
Becky T Durham, MSW, LCSW
Title
Owner
Phone
(321) 733-2299

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 000389 FL Primary

Addresses

Primary practice location

105 S Riverside Dr
Suite 100
Indialantic, FL 32903-4365

Mailing address

105 S Riverside Dr
Suite 100
Indialantic, FL 32903-4365
Phone (321) 733-2299

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100224000480 FL Part B Supplier - Clinic/Group Practice 3577607811 Receives reassigned benefits from 1 practitioner
Practice locations: Indialantic, FL

National Provider Directory

National Provider Directory

Locations

105 S Riverside Dr
Ste 100
Indialantic, FL 32903
Phone (321) 733-2299

105 S Riverside Dr
Ste 122
Indialantic, FL 32903
Phone (321) 506-4224

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1266883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266883200000",
    "number": "1245552876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S RIVERSIDE DR",
            "address_2": "SUITE 100",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329034365",
            "telephone_number": "321-733-2299",
            "fax_number": "321-733-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S RIVERSIDE DR",
            "address_2": "SUITE 100",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329034365",
            "telephone_number": "321-733-2299",
            "fax_number": "321-733-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BECKY DURHAM-FLINT, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-23",
        "last_updated": "2010-02-23",
        "status": "A",
        "authorized_official_last_name": "DURHAM",
        "authorized_official_first_name": "BECKY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-733-2299",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "000389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indialantic, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.