NPIMap

Organization Active NPI

Kaleidoscope Interventions

  • Behavior Analyst
  • Rockledge, FL
National Provider Identifier
1902200116
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
KALEIDOSCOPE INTERVENTIONS
Practice address
5830 US Highway 1 Ste 104
Rockledge, FL 32955-5704
Phone
(321) 609-9007
NPI assigned
Oct 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Authorized official

Name
Pamela Furr
Title
Ceo and Managing Member
Phone
(321) 372-6813

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

5830 US Highway 1 Ste 104
Rockledge, FL 32955-5704

Mailing address

125 E Nasa Blvd Ste 104
Melbourne, FL 32901-1900
Phone (321) 265-4429

Other practice location 1

2180 Julian Ave NE
Palm Bay, FL 32905-4020
Phone (321) 412-9838

Other practice location 2

125 E Nasa Blvd
Melbourne, FL 32901-1900
Phone (321) 372-6813

Other identifiers 9

IdentifierTypeStateIssuer
GRP2008OtherUNITED HEALTHCARE
014022600MedicaidFL
0089AOtherBLUE CROSS BLUE SHEILD
4642140OtherCIGNA
4953527OtherAETNA
5670969OtherCIGNA
5670970OtherCIGNA
GF43SOtherFLORIDA BLUE
017449700MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Melbourne Direct

National Provider Directory

National Provider Directory

Locations

125 E Nasa Blvd
Ste 104
Melbourne, FL 32901

125 E Nasa Blvd
Melbourne, FL 32901
Phone (321) 345-4232

2180 Julian Ave NE
Palm Bay, FL 32905
Phone (321) 345-0861

5830 US Highway 1
Ste 104
Rockledge, FL 32955
Phone (321) 426-7759

Practitioners & affiliated clinicians

Practitioners 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602115200000",
    "number": "1902200116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E NASA BLVD STE 104",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011900",
            "telephone_number": "321-265-4429",
            "fax_number": "321-765-6434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5830 US HIGHWAY 1 STE 104",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329555704",
            "telephone_number": "321-609-9007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2180 Julian Ave NE",
            "address_purpose": "LOCATION",
            "city": "Palm Bay",
            "state": "FL",
            "postal_code": "329054020",
            "country_code": "US",
            "telephone_number": "321-412-9838",
            "fax_number": "321-765-6434",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 E Nasa Blvd",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329011900",
            "country_code": "US",
            "telephone_number": "321-372-6813",
            "fax_number": "321-765-6434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KALEIDOSCOPE INTERVENTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-17",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A",
        "authorized_official_last_name": "FURR",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "CEO AND MANAGING MEMBER",
        "authorized_official_telephone_number": "321-372-6813"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "GRP2008",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014022600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "0089A",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4642140",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4953527",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5670969",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5670970",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "GF43S",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017449700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Melbourne",
            "affiliation": "N",
            "endpointDescription": "Main Office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Melbourne",
            "address_1": "125 E Nasa Blvd Ste 104",
            "city": "Melbourne",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329011900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.