Individual provider Active NPI

Caitlyn Elizabeth Wyant

  • Behavior Analyst
  • Fort Walton Beach, FL
National Provider Identifier
1558979708
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
124 Miracle Strip Pkwy SW Unit 503
Fort Walton Beach, FL 32548-6661
Phone
(850) 301-0438
NPI assigned
Jul 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

124 Miracle Strip Pkwy SW Unit 503
Fort Walton Beach, FL 32548-6661

Mailing address

124 Miracle Strip Pkwy SW Unit 503
Fort Walton Beach, FL 32548-6661

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL admin@abhatherapy@gmail.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1558979708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 MIRACLE STRIP PKWY SW UNIT 503",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325486661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 MIRACLE STRIP PKWY SW UNIT 503",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325486661",
            "telephone_number": "850-301-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYANT",
        "first_name": "CAITLYN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "admin@abhatherapy@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "124 Miracle Strip Pkwy SW Unit 503",
            "city": "Fort Walton Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325486661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; 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.