NPIMap

Organization Active NPI

Polk County Drug Court

  • Addiction (Substance Use Disorder) Counselor
  • Bartow, FL
National Provider Identifier
1467405597
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1453AD187401 Issued in FL
Legal business name
POLK COUNTY DRUG COURT
Practice address
255 N Broadway Ave
Bartow, FL 33830-3912
Phone
(863) 534-4983
Fax
(863) 534-5854
NPI assigned
May 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jim B. Hornsby Sr., L.M.H.C., C.A.P.
Title
Drug Court Manager
Phone
(863) 534-4503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X 1453AD187401 FL Primary

Addresses

Primary practice location

255 N Broadway Ave
Bartow, FL 33830-3912

Mailing address

255 N Broadway Ave
Bartow, FL 33830-3912
Phone (863) 534-4983

National Provider Directory

National Provider Directory
Tax ID family
Polk County Board of County10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

255 N Broadway Ave
Bartow, FL 33830
Phone (863) 534-4983

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467405597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 N BROADWAY AVE",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338303912",
            "telephone_number": "863-534-4983",
            "fax_number": "863-534-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N BROADWAY AVE",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338303912",
            "telephone_number": "863-534-4983",
            "fax_number": "863-534-5854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLK COUNTY DRUG COURT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HORNSBY",
        "authorized_official_first_name": "JIM",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "DRUG COURT MANAGER",
        "authorized_official_telephone_number": "863-534-4503",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "L.M.H.C., C.A.P."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "1453AD187401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartow, FL

Sources for this page

  • 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.