NPIMap

Organization Active NPI

Developmental Learning Center, Inc

  • Occupational Therapist
  • Jacksonville, FL
National Provider Identifier
1477518587
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
DEVELOPMENTAL LEARNING CENTER, INC
Practice address
4101-1 College St
Jacksonville, FL 32205-5318
Phone
(904) 387-0370
Fax
(904) 387-0156
NPI assigned
Apr 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Authorized official

Name
Mrs. Heather Corey
Title
Ceo
Phone
(904) 387-0370

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X Primary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Developmentally Disabled Services Day Training Agency 251C00000X 041802 FL

Addresses

Primary practice location

4101-1 College St
Jacksonville, FL 32205-5318

Mailing address

4101-1 College Street
Jacksonville, FL 32205-5318
Phone (904) 387-0370

Other identifiers 2

IdentifierTypeStateIssuer
679242196MedicaidFL
880242400MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Developmental Learning Center Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1477518587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101-1 COLLEGE STREET",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322055318",
            "telephone_number": "904-387-0370",
            "fax_number": "904-387-0156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101-1 COLLEGE ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322055318",
            "telephone_number": "904-387-0370",
            "fax_number": "904-387-0156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENTAL LEARNING CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A",
        "authorized_official_last_name": "COREY",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-387-0370",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "FL",
            "license": "041802",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "679242196",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "880242400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.