Imagine Blue ABA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

IMAGINE BLUE ABA

Practice address

5426 Windbrush Dr
Tampa, FL 33625-4050

Phone

(813) 713-1161

NPI assigned

Feb 7, 2024

Organization subpart

No

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

Authorized official

Name

Shayli M Gerard, BCBANPI 1033623343

Title

Owner

Phone

(561) 761-9120

Specialties & licenses 1

Addresses

Practitioners 1

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

• Shayli M Gerard, MS

  • Behavior Analyst
  • West Palm Beach, FL
  • NPI 1033623343
  NPD Authorized official

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

{
    "created_epoch": "1707264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1548024938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5426 WINDBRUSH DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336254050",
            "telephone_number": "813-713-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5426 WINDBRUSH DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336254050",
            "telephone_number": "813-713-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINE BLUE ABA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "GERARD",
        "authorized_official_first_name": "SHAYLI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-761-9120",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Matthew Illes, B.A
• Karl Armistead Illig, M.D.
• Chinwe Ifeyinwa Iloanya
• Chiamaka Ilonzo, M.D.
• Imad Razvi MD LLC
• Imagine Pediatrics of Florida LLC
• Taariq Emran Imami
• Donya Salmasinia Imanirad, M.D.
• Iman Imanirad, M.D.
• Aischelly Imas Prieto

• Behavior Analyst in Tampa, FL
• Providers in Tampa, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; 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.