Active NPI
Jonathan Blake Lunsford
- Developmental Therapist
- Pompano Beach, FL
National Provider Identifier
1457649550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- License
- 25562702
- Practice address
- 2708 NE 14TH St
Suite 5
Pompano Beach, FL 33062-3565 - Phone
- (888) 880-9270
- NPI assigned
- Jul 11, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | 25562702 | NC | Primary |
Addresses
Primary practice location
2708 NE 14TH St
Suite 5
Pompano Beach, FL 33062-3565
Mailing address
9530 Rocky River Rd
Harrisburg, NC 28075-8609
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25562702 | NC | MD | Developmental Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310342400000",
"number": "1457649550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9530 ROCKY RIVER RD",
"city": "HARRISBURG",
"state": "NC",
"postal_code": "280758609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2708 NE 14TH ST",
"address_2": "SUITE 5",
"city": "POMPANO BEACH",
"state": "FL",
"postal_code": "330623565",
"telephone_number": "888-880-9270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNSFORD",
"first_name": "JONATHAN",
"middle_name": "BLAKE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-11",
"last_updated": "2011-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "NC",
"license": "25562702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pompano Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.