NPIMap

Organization Active NPI

Easterseals Northeast Central Florida

  • Multi-Specialty Clinic/Center
  • Daytona Beach, FL
National Provider Identifier
1881898559
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
EASTERSEALS NORTHEAST CENTRAL FLORIDA
Practice address
1219 Dunn Ave
Daytona Beach, FL 32114
Phone
(386) 255-4568
Fax
(386) 252-3403
NPI assigned
Jun 14, 2007
Last updated
Apr 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Authorized official

Name
Beverly Johsnon
Title
Ceo
Phone
(386) 255-4568

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Physical Therapist 225100000X
Occupational Therapist 225X00000X
Speech-Language Pathologist 235Z00000X

Addresses

Primary practice location

1219 Dunn Ave
Daytona Beach, FL 32114

Mailing address

1219 Dunn Ave
Daytona Beach, FL 32114-2405
Phone (386) 255-4568

Other identifiers 1

IdentifierTypeStateIssuer
880172000MedicaidFL

Other names 1

  • Easter Seals of Volusia and Flagler Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Easter Seal Society of25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1881898559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 DUNN AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142405",
            "telephone_number": "386-255-4568",
            "fax_number": "386-252-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 DUNN AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32114",
            "telephone_number": "386-255-4568",
            "fax_number": "386-252-3403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERSEALS NORTHEAST CENTRAL FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A",
        "authorized_official_last_name": "JOHSNON",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "386-255-4568"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "880172000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Easter Seals of Volusia and Flagler",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Easter Seals of Volusia and Flagler",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.

Verify at the official NPI Registry.