Organization Active NPI

Spectrum Sprouts ABA Therapy

  • Pediatric Neurodevelopmental Disabilities Physician
  • Philadelphia, PA
National Provider Identifier
1508713017
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Neurodevelopmental Disabilities PhysicianTaxonomy code 2080P0008X
Legal business name
SPECTRUM SPROUTS ABA THERAPY
Practice address
5811 Germantown Ave
Philadelphia, PA 19144-2138
Phone
(267) 808-5801
NPI assigned
Mar 13, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Authorized official

Name
Reginald Bullock
Title
Executive Director
Phone
(267) 808-5801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Neurodevelopmental Disabilities PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0008X Primary

Addresses

Primary practice location

5811 Germantown Ave
Philadelphia, PA 19144-2138

Mailing address

5811 Germantown Ave
Philadelphia, PA 19144-2138

National Provider Directory

National Provider Directory

Locations

5811 Germantown Ave
Philadelphia, PA 19144
Phone (267) 808-5801

NPI Registry JSON

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

{
    "created_epoch": "1773360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773360000000",
    "number": "1508713017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5811 GERMANTOWN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191442138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5811 GERMANTOWN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191442138",
            "telephone_number": "267-808-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM SPROUTS ABA THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-13",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "267-808-5801"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; 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.