ADVANCED BEHAVIORAL CLINICIANS (NPI# 1639793326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639793326 |
| Entity Type | Organization |
| Organization Name | ADVANCED BEHAVIORAL CLINICIANS |
| Practice Address |
2740 Coconut Bay Ln Unit 3g Sarasota FL 34237-3055 |
| Practice Telephone | 9418703600 |
| Practice Fax Number | 7279988401 |
| Mailing Telephone | 9418703600 |
| Mailing Fax Number | 7279988401 |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2020-06-23 |
| Authorized Official Name | ADAIR LYNNE DEICKE (OWNER/CEO) |
| Authorized Official Telephone | 7272399938 |
| Authorized Official Credential | PMHNP-BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 008642300 | 05 |
| Other Name | Type Code |
|---|---|
| Adair Deicke | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1991 Hyde Park St, Sarasota, FL 342393612 | 7272399938 | 7279988041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134741218 | Advanced Behavioral Clinicians | Nurse Practitioner | 2740 Coconut Bay Ln Unit 3g, Sarasota, FL 34237-3055 | 2020-05-12 |
| Street Address |
2740 COCONUT BAY LN UNIT 3G |
| City | SARASOTA |
| State | FL |
| Zip Code | 34237-3055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922185628 | Adair Lynne Deicke | Nurse Practitioner | 2740 Coconut Bay Ln Unit 3g, Sarasota, FL 34237-3055 | 2006-11-01 |
| 1134741218 | Advanced Behavioral Clinicians | Nurse Practitioner | 2740 Coconut Bay Ln Unit 3g, Sarasota, FL 34237-3055 | 2020-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215595004 | Brett Sondag | Counselor | 2033 Wood St., Ste. 215, 218, 220, Sarasota, FL 34237 | 2019-06-05 |
| 1730608274 | Stacy Lee Panzella | Behavior Technician | 2461 8th Street, Unit 52, Sarasora, FL 34237 | 2017-09-15 |
| 1871010942 | Katy Darlene Wendel | Registered Nurse | 1231 N. Tuttle Avenue, Sarasota, FL 34237 | 2017-08-29 |
| 1639699663 | Mark W. Phillips | Nurse Practitioner | 1 S School Ave Ste 200, Sarasota, FL 34237 | 2017-06-21 |
| 1295075281 | Baltimore Orioles Limited Partnership | Non-Pharmacy Dispensing Site | 1090 Euclid Ave, Ed Smith-baltimore Orioles-athletic Training Department, Sarasota, FL 34237 | 2013-02-27 |
| 1164786877 | Robin Susan Bernstein | Counselor | 520 Payne Pkwy, Sarasota, FL 34237 | 2012-06-27 |
| 1598053787 | Linda B Sherr | Counselor | 504 Payne Parkway, Sarasota, FL 34237 | 2011-07-21 |
| 1245463405 | Lydia Gay Corn | Internal Medicine | 80 S Tuttle Avenue, Suite 100, Sarasota, FL 34237 | 2009-09-03 |
| 1316187156 | John R Picken Md | General Practice | 3530 Fruitville Road, Sarasoa, FL 34237 | 2009-03-05 |
| 1124299193 | Manav Malik | Dentist | 3103 Fruitville Rd, Sarasota, FL 34237 | 2008-03-18 |
| Find all providers in zip 34237 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659988871 | Caleb Rose | Nurse Practitioner | 1852 Hillview St Ste 301, Sarasota, FL 34239-3638 | 2020-10-01 |
| 1043823214 | Rachelle Ann Kutzko | Nurse Practitioner | 3333 Cattlemen Rd Ste 106, Sarasota, FL 34232-6057 | 2020-08-28 |
| 1003428707 | Derek Jason Sisk | Nurse Practitioner | 3554 65th Avenue Cir E, Sarasota, FL 34243-4116 | 2020-08-24 |
| 1104437128 | Heather Wicklund | Nurse Practitioner | 1626 Brookhouse Dr Unit 234, Sarasota, FL 34231-8982 | 2020-08-13 |
| 1205460540 | Olga Nielsen | Nurse Practitioner | 1857 Oak Branch Dr, Sarasota, FL 34232-6658 | 2020-02-25 |
| 1194284737 | Lori-ann T Luer | Nurse Practitioner | 3245 Old Oak Dr, Sarasota, FL 34239-5020 | 2019-03-13 |
| 1881150555 | Steven Mazar | Nurse Practitioner | 5151 Old Ashwood Dr, Sarasota, FL 34233-3491 | 2019-02-18 |
| 1295204741 | Beth Robin Domino | Nurse Practitioner | 700 Cocoanut Ave Unit 326, Sarasota, FL 34236-5063 | 2018-11-14 |
| 1235634700 | Marathon Health LLC | Nurse Practitioner | 237 Payne Pkwy Unit 101, Sarasota, FL 34237-7018 | 2018-03-27 |
| 1861904567 | Linda Suzanne Martell | Nurse Practitioner | 8383 S. Tamiami Trail, Suite 115, Sarasota, FL 34238-3046 | 2017-11-02 |
| Find all providers in SARASOTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.