1 Source Holdings, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

1 SOURCE HOLDINGS, LLC

Practice address

4851 Tamiami TRL N Ste 200
Naples, FL 34103-3098

Phone

(619) 865-2400

NPI assigned

May 23, 2022

Last updated

May 23, 2022By 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

Brian Robert Twigger

Title

President

Phone

(619) 865-2400

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653264000000",
    "number": "1669110417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4851 TAMIAMI TRL N STE 200",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341033098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4851 TAMIAMI TRL N STE 200",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341033098",
            "telephone_number": "619-865-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1 SOURCE HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A",
        "authorized_official_last_name": "TWIGGER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-865-2400"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Naples",
            "affiliation": "N",
            "endpointDescription": "Other",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Naples",
            "address_1": "4851 Tamiami Trl N Ste 200",
            "city": "Naples",
            "state": "FL",
            "country_code": "US",
            "postal_code": "341033098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; 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.