Organization Active NPI

Building Momentum Inc.

  • Clinical Psychologist
  • Plantation, FL
National Provider Identifier
1710075916
Registry record updated Oct 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 6164 Issued in FL
Legal business name
BUILDING MOMENTUM INC.
Practice address
300 S Pine Island Rd
Suite 227
Plantation, FL 33324-2673
Phone
(954) 382-4889
Fax
(954) 382-4884
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2008

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

Authorized official

Name
Dr. Grace Elizabeth Sidberry, PH.D.NPI 1154335495
Title
President
Phone
(954) 382-4889

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY 6164 FL Primary

Addresses

Primary practice location

300 S Pine Island Rd
Suite 227
Plantation, FL 33324-2673

Mailing address

300 S Pine Island Rd
Suite 227
Plantation, FL 33324-2673
Phone (954) 382-4889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061113000030 FL Part B Supplier - Clinic/Group Practice 7315945094 Receives reassigned benefits from 1 practitioner
Practice locations: Plantation, FL

National Provider Directory

National Provider Directory

Locations

300 S Pine Island Rd
Ste 227
Plantation, FL 33324
Phone (305) 215-2011

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224028800000",
    "number": "1710075916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S PINE ISLAND RD",
            "address_2": "SUITE 227",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242673",
            "telephone_number": "954-382-4889",
            "fax_number": "954-382-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S PINE ISLAND RD",
            "address_2": "SUITE 227",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242673",
            "telephone_number": "954-382-4889",
            "fax_number": "954-382-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUILDING MOMENTUM INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2008-10-15",
        "status": "A",
        "authorized_official_last_name": "SIDBERRY",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-382-4889",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 6164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.