Organization Active NPI

White Industries, LLC

Doing business as Back 2 Basics Behavior Therapy

  • Behavior Analyst
  • Panama City, FL
National Provider Identifier
1487148383
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
WHITE INDUSTRIES, LLC
Doing business as
Back 2 Basics Behavior Therapy
Practice address
2808 Hawks Landing Blvd
Panama City, FL 32405-6659
Phone
(615) 948-7203
NPI assigned
Jun 15, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2018

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

Authorized official

Name
Mrs. Alicia N White, BCBANPI 1083910509
Title
Owner/Operator
Phone
(615) 948-7203

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

2808 Hawks Landing Blvd
Panama City, FL 32405-6659

Mailing address

2808 Hawks Landing Blvd
Panama City, FL 32405-6659
Phone (615) 948-7203

Other identifiers 1

IdentifierTypeStateIssuer
017740500MedicaidFL

Other names 1

  • Back 2 Basics Behavior Therapy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1529020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529020800000",
    "number": "1487148383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 HAWKS LANDING BLVD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324056659",
            "telephone_number": "615-948-7203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 HAWKS LANDING BLVD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324056659",
            "telephone_number": "615-948-7203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE INDUSTRIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-15",
        "last_updated": "2018-06-15",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "615-948-7203",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017740500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back 2 Basics Behavior Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Back 2 Basics Behavior Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; 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.