NPIMap

Organization Active NPI

Baytree Behavioral Health PA

  • Psychologist
  • Melbourne, FL
National Provider Identifier
1447302633
Registry record updated Dec 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY 6051 Issued in FL
Legal business name
BAYTREE BEHAVIORAL HEALTH PA
Practice address
1370 Bedford Dr
Suite 106
Melbourne, FL 32940-1993
Phone
(321) 253-8887
Fax
(321) 253-8878
NPI assigned
Jan 17, 2007
Last updated
Dec 13, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2012

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

Authorized official

Name
Dr. L. Scott Fairchild, PSY. D.NPI 1497807994
Title
President
Phone
(321) 253-8887

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY 6051 FL Primary

Addresses

Primary practice location

1370 Bedford Dr
Suite 106
Melbourne, FL 32940-1993

Mailing address

1370 Bedford Dr
Suite 106
Melbourne, FL 32940-1993
Phone (321) 253-8887

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041221000941 FL Part B Supplier - Clinic/Group Practice 0244298313 Receives reassigned benefits from 8 practitioners
Practice locations: Melbourne, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355356800000",
    "number": "1447302633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 BEDFORD DR",
            "address_2": "SUITE 106",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401993",
            "telephone_number": "321-253-8887",
            "fax_number": "321-253-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 BEDFORD DR",
            "address_2": "SUITE 106",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401993",
            "telephone_number": "321-253-8887",
            "fax_number": "321-253-8878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYTREE BEHAVIORAL HEALTH PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2012-12-13",
        "status": "A",
        "authorized_official_last_name": "FAIRCHILD",
        "authorized_official_first_name": "L.",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-253-8887",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY. D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY 6051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; 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.