NPIMap

Organization Active NPI

Florida Autism Center

  • Behavior Analyst
  • St Augustine, FL
National Provider Identifier
1790146462
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
FLORIDA AUTISM CENTER
Practice address
124 Capulet Drive
St Augustine, FL 32092
Phone
(386) 951-3044
NPI assigned
Mar 9, 2016
Last updated
Nov 10, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
SCP AUTISM SERVICES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Authorized official

Name
Jason Owen
Title
Ceo
Phone
(470) 816-6449

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X NU
Behavior Analyst 103K00000X NU Primary
Community/Behavioral Health Agency 251S00000X NU
Assistant Behavior Analyst 106E00000X NU
Behavior Technician 106S00000X NU

Addresses

Primary practice location

124 Capulet Drive
St Augustine, FL 32092

Mailing address

300 International Pkwy Ste 200
Lake Mary, FL 32746-5028
Phone (470) 816-6449

Other identifiers 1

IdentifierTypeStateIssuer
595665MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Florida Autism Center81 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

124 Capulet Dr
St Augustine, FL 32092
Phone (904) 429-3859

Practitioners & affiliated clinicians

Practitioners 2

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": "1457481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668038400000",
    "number": "1790146462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 INTERNATIONAL PKWY STE 200",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465028",
            "telephone_number": "470-816-6449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 CAPULET DRIVE",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "32092",
            "telephone_number": "386-951-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA AUTISM CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SCP AUTISM SERVICES LLC",
        "enumeration_date": "2016-03-09",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A",
        "authorized_official_last_name": "OWEN",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "470-816-6449"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "595665",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.