Active NPI
Eden Stone
- Early Intervention Provider Agency
- Kissimmee, FL
National Provider Identifier
1467953695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Early Intervention Provider Agency
- Practice address
- 1200 N Central Ave
Kissimmee, FL 34741-4450 - Phone
- (407) 925-5623
- NPI assigned
- Feb 22, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Early Intervention Provider Agency | 252Y00000X | Primary | ||
| Behavior Technician | 106S00000X | |||
| Developmental Therapist | 222Q00000X |
Addresses
Primary practice location
1200 N Central Ave
Kissimmee, FL 34741-4450
Mailing address
7 Black Jack Cir
Port Orange, FL 32128-6751
Phone (352) 332-8588
Other practice location 1
7 Black Jack Cir
Port Orange, FL 32128-6751
Phone (352) 332-8588 ext. 1
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S | Medicaid | FL |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638403200000",
"number": "1467953695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 BLACK JACK CIR",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321286751",
"telephone_number": "352-332-8588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N CENTRAL AVE",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347414450",
"telephone_number": "407-925-5623"
}
],
"practiceLocations": [
{
"address_1": "7 Black Jack Cir",
"address_purpose": "LOCATION",
"city": "Port Orange",
"state": "FL",
"postal_code": "321286751",
"country_code": "US",
"telephone_number": "352-332-8588 x1",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STONE",
"first_name": "EDEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-22",
"last_updated": "2021-12-02",
"certification_date": "2021-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"state": null,
"license": null,
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "S",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.