Psychiatry Services of Osceola LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

PSYCHIATRY SERVICES OF OSCEOLA LLC

Practice address

810 N Rose Ave
Kissimmee, FL 34741-4944

Phone

(407) 847-0113

NPI assigned

Oct 27, 2021

Organization subpart

Yes

Parent organization

PSYCHIATRY SERVICES OF OSCEOLA LLCAs reported in NPPES

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

Authorized official

Name

William Tedrick Johnson

Title

Vice President

Phone

(615) 372-3375

Specialties & licenses 1

Addresses

Tax ID family

Psychiatry Services of Osceola LLC2 organizations share this tax ID, including this one

Part of

Psychiatry Services of Osceola LLC

Other organizations with this tax ID 1

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

• Psychiatry Services of Osceola LLC

  • Psychiatry Physician
  • Kissimmee, FL
  • NPI 1790181618
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Psychiatry Services of Osceola LLC

  • Psychiatry Physician
  • Kissimmee, FL
  • NPI 1790181618
  NPPES parent name

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635292800000",
    "number": "1760146575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274692",
            "telephone_number": "615-372-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 N ROSE AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414944",
            "telephone_number": "407-847-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRY SERVICES OF OSCEOLA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PSYCHIATRY SERVICES OF OSCEOLA LLC",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-08",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "TEDRICK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-372-3375"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.