NPIMap

Organization Active NPI

Developmental Centers of Georgia

  • Behavior Analyst
  • Port Saint Lucie, FL
National Provider Identifier
1386581528
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
DEVELOPMENTAL CENTERS OF GEORGIA
Practice address
550 SE Port St Lucie Blvd Unit 3
Port Saint Lucie, FL 34984-5108
Phone
(954) 825-3317
NPI assigned
May 4, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Authorized official

Name
Theods Fulmore Jr.
Title
Office Manager
Phone
(954) 825-3317

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

550 SE Port St Lucie Blvd Unit 3
Port Saint Lucie, FL 34984-5108

Mailing address

550 SE Port St Lucie Blvd Unit 3
Port Saint Lucie, FL 34984-5108
Phone (954) 825-3317

National Provider Directory

National Provider Directory

Locations

550 SE Port St Lucie Blvd
Unit 3
Port Saint Lucie, FL 34984
Phone (954) 825-3317

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1777852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777852800000",
    "number": "1386581528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 SE PORT ST LUCIE BLVD UNIT 3",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349845108",
            "telephone_number": "954-825-3317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 SE PORT ST LUCIE BLVD UNIT 3",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349845108",
            "telephone_number": "954-825-3317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENTAL CENTERS OF GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-04",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A",
        "authorized_official_last_name": "FULMORE",
        "authorized_official_first_name": "THEODS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "954-825-3317",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; 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.