Bloomspark Behavior Services, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

BLOOMSPARK BEHAVIOR SERVICES, LLC

Practice address

4241 Spanish Trail PL
Pensacola, FL 32504-8561

Phone

(850) 290-2356

Fax

(888) 511-0692

NPI assigned

Feb 22, 2018

Organization subpart

No

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

Authorized official

Name

Peyton Foshee, BCBA

Title

Behavior Analyst

Phone

(850) 290-2356

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519257600000",
    "number": "1639670839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4241 SPANISH TRAIL PL",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048561",
            "telephone_number": "850-290-2356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4241 SPANISH TRAIL PL",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048561",
            "telephone_number": "850-290-2356",
            "fax_number": "888-511-0692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMSPARK BEHAVIOR SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-22",
        "last_updated": "2018-02-22",
        "status": "A",
        "authorized_official_last_name": "FOSHEE",
        "authorized_official_first_name": "PEYTON",
        "authorized_official_title_or_position": "BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "850-290-2356",
        "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": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.