Organization Active NPI

The Arc of the St. Johns

  • Behavior Analyst
  • St Augustine, FL
National Provider Identifier
1487070744
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
0-13-5635 Issued in FL
Legal business name
THE ARC OF THE ST. JOHNS
Practice address
2101 Arc Dr
St Augustine, FL 32084-0512
Phone
(386) 846-8407
NPI assigned
Mar 11, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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

Authorized official

Name
Mrs. Lori Ann Bolt, BCBA
Title
Senior Behavior Analyst
Phone
(904) 824-7249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 0-13-5635 FL Primary

Addresses

Primary practice location

2101 Arc Dr
St Augustine, FL 32084-0512

Mailing address

2101 Arc Dr
St Augustine, FL 32084-0512
Phone (386) 846-8407

National Provider Directory

National Provider Directory
Tax ID family
The Arc of the St Johns 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.

NPI Registry JSON

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

{
    "created_epoch": "1394496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394496000000",
    "number": "1487070744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 ARC DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320840512",
            "telephone_number": "386-846-8407",
            "fax_number": "904-824-8063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 ARC DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320840512",
            "telephone_number": "386-846-8407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ARC OF THE ST. JOHNS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-11",
        "last_updated": "2014-03-11",
        "status": "A",
        "authorized_official_last_name": "BOLT",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "SENIOR BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "904-824-7249",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "0-13-5635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; 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.