Baptist Behavioral Health, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

BAPTIST BEHAVIORAL HEALTH, LLC

Practice address

3650 NW Devane St
Lake City, FL 32055-8730

Phone

(904) 376-3800

Fax

(904) 376-3998

NPI assigned

Jun 28, 2022

Organization subpart

Yes

Parent organization

BAPTIST BEHAVIORAL HEALTH, LLCAs reported in NPPES

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

Authorized official

Name

Elizabeth Tish De Medici

Title

Credentialing MGR

Phone

(904) 376-3800

Specialties & licenses 1

Addresses

Tax ID family

Baptist Behavioral Health LLC3 organizations share this tax ID, including this one

Part of

Baptist Behavioral Health LLC

Other organizations with this tax ID 2

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

• Baptist Behavioral Health, LLC

  • Psychologist
  • Jacksonville, FL
  • NPI 1164155974
  NPD tax ID
• Baptist Behavioral Health, LLC

  • Behavior Analyst
  • Jacksonville, FL
  • NPI 1932831930
  NPD tax ID

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656374400000",
    "number": "1295467207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748519",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748519",
            "telephone_number": "904-376-3800",
            "fax_number": "904-376-3998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 NW DEVANE ST",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320558730",
            "telephone_number": "904-376-3800",
            "fax_number": "904-376-3998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAPTIST BEHAVIORAL HEALTH, LLC",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A",
        "authorized_official_last_name": "DE MEDICI",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "TISH",
        "authorized_official_title_or_position": "CREDENTIALING  MGR",
        "authorized_official_telephone_number": "904-376-3800"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Ballance
• Laura K Ballinger
• Bercela Kay Banda, LCSW
• Daycia E Bandy
• Prabir Banik, M.D.
• Baptist Specialty Physicians Inc
• Juan R Baralt, M.D.
• Ann M Barber, M.D.
• Allison B Baris, ARNP
• Elizabeth Barlow

• Behavior Analyst in Lake City, FL
• Providers in Lake City, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.