NPIMap

Organization Active NPI

Baptist Behavioral Health, LLC

  • Behavior Analyst
  • Jacksonville, FL
National Provider Identifier
1932831930
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BAPTIST BEHAVIORAL HEALTH, LLC
Practice address
1650 Prudential Drive
Ste 102
Jacksonville, FL 32207-8149
Phone
(904) 376-3800
Fax
(904) 376-3998
NPI assigned
Jun 28, 2022
Last updated
Jun 28, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
BAPTIST BEHAVIORAL HEALTH, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Authorized official

Name
Elizabeth Tish De Medici
Title
Credentialing MGR
Phone
(904) 376-3800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

1650 Prudential Drive
Ste 102
Jacksonville, FL 32207-8149

Mailing address

PO Box 748519
Atlanta, GA 30374-8519
Phone (904) 375-3800

National Provider Directory

National Provider Directory
Tax ID family
Baptist Behavioral Health LLC3 organizations share this tax ID, including this one
Part of
Baptist Behavioral Health LLC

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656374400000",
    "number": "1932831930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748519",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748519",
            "telephone_number": "904-375-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 PRUDENTIAL DRIVE",
            "address_2": "STE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078149",
            "telephone_number": "904-376-3800",
            "fax_number": "904-376-3998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAPTIST BEHAVIORAL HEALTH, LLC",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A",
        "authorized_official_last_name": "DE MEDICI",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "TISH",
        "authorized_official_title_or_position": "CREDENTIALING MGR",
        "authorized_official_telephone_number": "904-376-3800"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.