NPIMap

Organization Active NPI

Emerald Coast Autism Center

  • Behavior Analyst
  • Niceville, FL
National Provider Identifier
1649508912
Registry record updated Nov 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
EMERALD COAST AUTISM CENTER
Practice address
200 Partin Dr N
Niceville, FL 32578-1244
Phone
(850) 279-3000
Fax
(850) 678-0922
NPI assigned
Nov 25, 2009
Last updated
Nov 25, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2009

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

Authorized official

Name
Mrs. Staci S. Berryman, MSED, BCBANPI 1033344700
Title
Director
Phone
(850) 279-3000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X FL Primary

Addresses

Primary practice location

200 Partin Dr N
Niceville, FL 32578-1244

Mailing address

200 Partin Dr N
Niceville, FL 32578-1244
Phone (850) 279-3000

National Provider Directory

National Provider Directory
Tax ID family
Emerald Coast Autism Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1259107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259107200000",
    "number": "1649508912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PARTIN DR N",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325781244",
            "telephone_number": "850-279-3000",
            "fax_number": "850-678-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PARTIN DR N",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325781244",
            "telephone_number": "850-279-3000",
            "fax_number": "850-678-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD COAST AUTISM CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-25",
        "last_updated": "2009-11-25",
        "status": "A",
        "authorized_official_last_name": "BERRYMAN",
        "authorized_official_first_name": "STACI",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "850-279-3000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSED, BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; 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.