Active NPI
Jordan Holt, BCBA
- Behavior Analyst
- Eustis, FL
National Provider Identifier
1851620371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-09-5895
- Practice address
- 2138 Sandridge Cir
Eustis, FL 32726-4486 - Phone
- (478) 954-4278
- NPI assigned
- Dec 11, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-09-5895 | FL | Primary |
Addresses
Primary practice location
2138 Sandridge Cir
Eustis, FL 32726-4486
Mailing address
2138 Sandridge Cir
Eustis, FL 32726-4486
Phone (478) 954-4278
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009093700 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Autism Center | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Behavior Analyst
- Clermont, FL
- NPI 1144763202
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689897600000",
"number": "1851620371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2138 SANDRIDGE CIR",
"city": "EUSTIS",
"state": "FL",
"postal_code": "327264486",
"telephone_number": "478-954-4278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2138 SANDRIDGE CIR",
"city": "EUSTIS",
"state": "FL",
"postal_code": "327264486",
"telephone_number": "478-954-4278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLT",
"first_name": "JORDAN",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-12-11",
"last_updated": "2023-07-21",
"certification_date": "2023-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "1-09-5895",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009093700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eustis, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.