Florida State University

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

FLORIDA STATE UNIVERSITY

Practice address

937 W. Jefferson St.
Tallahassee, FL 32306-4190

Phone

(850) 644-2288

Fax

(850) 644-1043

NPI assigned

May 16, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bruce C. Prevatt, PH.D.

Title

Director, Employee Assistance PRGM

Phone

(850) 644-2288

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417164997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 W. JEFFERSON ST.",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323064190",
            "telephone_number": "850-644-2288",
            "fax_number": "850-644-1043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 W. JEFFERSON ST.",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323064190",
            "telephone_number": "850-644-2288",
            "fax_number": "850-644-1043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PREVATT",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "DIRECTOR, EMPLOYEE ASSISTANCE PRGM",
        "authorized_official_telephone_number": "850-644-2288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.