NPIMap

Organization Active NPI

Blossom Behavioral Services

  • Behavior Analyst
  • Newport News, VA
National Provider Identifier
1447753082
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BLOSSOM BEHAVIORAL SERVICES
Practice address
763 J Clyde Morris Blvd Ste 1C
Newport News, VA 23601-1533
Phone
(757) 524-2510
NPI assigned
Mar 9, 2018
Last updated
Apr 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Authorized official

Name
Kathryn Fitterer, BCBA, LBA
Title
Owner
Phone
(757) 524-2510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X VA Primary

Addresses

Primary practice location

763 J Clyde Morris Blvd Ste 1C
Newport News, VA 23601-1533

Mailing address

763 J Clyde Morris Blvd Ste 1C
Newport News, VA 23601-1533

Other practice location 1

8 San Jose Dr
Newport News, VA 23606
Phone (757) 524-2510

Other practice location 2

8 San Jose Dr
Newport News, VA 23606
Phone (757) 524-2510

National Provider Directory

National Provider Directory

Locations

1085 Loftis Blvd
Newport News, VA 23606
Phone (757) 524-2510

763 J Clyde Morris Blvd
Ste 1C
Newport News, VA 23601
Phone (757) 524-2510

8 San Jose Dr
Newport News, VA 23606
Phone (757) 524-2510

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618444800000",
    "number": "1447753082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 J CLYDE MORRIS BLVD STE 1C",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 J CLYDE MORRIS BLVD STE 1C",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011533",
            "telephone_number": "757-524-2510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 San Jose Dr",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "23606",
            "country_code": "US",
            "telephone_number": "757-524-2510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8 San Jose Dr",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "23606",
            "country_code": "US",
            "telephone_number": "757-524-2510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLOSSOM BEHAVIORAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-09",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A",
        "authorized_official_last_name": "FITTERER",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-524-2510",
        "authorized_official_credential": "BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.