Source Route Products, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-12-12087 Issued in FL

Legal business name

SOURCE ROUTE PRODUCTS, LLC

Doing business as

SRP, LLC

Practice address

3795 E Parsons Point Rd
Box 1047
Hernando, FL 34442-7701

Phone

(202) 480-9234

NPI assigned

Nov 5, 2012

Last updated

Nov 5, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kimberly Mills, PH.D, BCBA

Title

Member

Phone

(202) 480-9234

Specialties & licenses 1

Addresses

Other names 1

• SRP, LLC Doing business as

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

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352073600000",
    "number": "1639423247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3795 E PARSONS POINT RD",
            "address_2": "BOX 1047",
            "city": "HERNANDO",
            "state": "FL",
            "postal_code": "344427701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3795 E PARSONS POINT RD",
            "address_2": "BOX 1047",
            "city": "HERNANDO",
            "state": "FL",
            "postal_code": "344427701",
            "telephone_number": "202-480-9234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOURCE ROUTE PRODUCTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-05",
        "last_updated": "2012-11-05",
        "status": "A",
        "authorized_official_last_name": "MILLS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "202-480-9234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D, BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-12-12087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SRP, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madison Taylor Schires
• Fred R Shirley, PT
• Heather Leigh Smith, MS
• Jessica Nicole Smith, PHARMD
• Kevin Wayne Snodgrass, COTA/L
• Savanah Kay Starkey, PHARMD
• Mary Leah Stringer, ARNP
• Brittany Swan
• Ezer Dapanas Talaroc, PT
• Tampa General Medical Group Inc (TGMG General Surgery N. Essex Avenue)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; 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.