Active NPI
Jasmine Brown
- Behavior Technician
- Miramar Beach, FL
National Provider Identifier
1376254151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 495 Grand Blvd
Miramar Beach, FL 32550-1897 - Phone
- (754) 204-2089
- NPI assigned
- Dec 12, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Behavior Technician | 106S00000X | |||
| Behavior Technician | 106S00000X | FL | Primary |
Addresses
Primary practice location
495 Grand Blvd
Miramar Beach, FL 32550-1897
Mailing address
17 S de Villiers St
Pensacola, FL 32502-5511
Other practice location 1
9900 N Davis Hwy
Pensacola, FL 32514-8124
Phone (850) 607-6910
Other practice location 2
17 S De Villiers St
Pensacola, FL 32502-5511
Phone (850) 266-2700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 029583300 | Medicaid | FL |
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": "1670803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681776000000",
"number": "1376254151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 S DE VILLIERS ST",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325025511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "495 GRAND BLVD",
"city": "MIRAMAR BEACH",
"state": "FL",
"postal_code": "325501897",
"telephone_number": "754-204-2089"
}
],
"practiceLocations": [
{
"address_1": "9900 N Davis Hwy",
"address_purpose": "LOCATION",
"city": "Pensacola",
"state": "FL",
"postal_code": "325148124",
"country_code": "US",
"telephone_number": "850-607-6910",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "17 S De Villiers St",
"address_purpose": "LOCATION",
"city": "Pensacola",
"state": "FL",
"postal_code": "325025511",
"country_code": "US",
"telephone_number": "850-266-2700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROWN",
"first_name": "JASMINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-12",
"last_updated": "2023-04-18",
"certification_date": "2023-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "029583300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miramar Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.