BANYAN BOTKIN (NPI# 1851717425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851717425 |
| Entity Type | Individual |
| Full Name | BANYAN BOTKIN |
| Practice Address |
4308 Hanover Park Dr Jacksonville FL 32224-8602 |
| Practice Telephone | 9044651049 |
| Mailing Telephone | 9044651049 |
| Enumeration Date | 2014-03-06 |
| Last Update Date | 2014-03-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
4308 HANOVER PARK DR |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32224-8602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104891217 | Ehren L. Allen | Physical Therapist | 4308 Hanover Park Dr, Jacksonville, FL 32224-8602 | 2006-02-22 |
| 1881011625 | Virginia Lyon | Developmental Therapist | 4308 Hanover Park Dr, Jacksonville, FL 32224-8602 | 2014-03-18 |
| 1811328669 | Valeria Silver | Speech-Language Pathologist | 4308 Hanover Park Dr, Jacksonville, FL 32224-8602 | 2013-12-04 |
| 1487968632 | Tricia L Roth | Developmental Therapist | 4308 Hanover Park Dr, Jacksonville, FL 32224-8602 | 2010-07-29 |
| 1730400987 | Amanda D Frank | Developmental Therapist | 4308 Hanover Park Dr, Jacksonville, FL 32224-8602 | 2010-06-22 |
| 1568799088 | Jennifer Renee Nitz | Occupational Therapist | 4308 Hanover Park Dr, Jacksonville, FL 32224-8602 | 2009-11-04 |
| 1457687980 | Anasuya Banerjee | Developmental Therapist | 4308 Hanover Park Dr, Jacksonville, FL 32224-8602 | 2009-10-17 |
| 1669613832 | Allen Therapy Services, Pllc | Speech-Language Pathologist | 4308 Hanover Park Dr, Jacksonville, FL 32224-8602 | 2009-03-17 |
| 1851582167 | Lori Mccullough Allen | Speech-Language Pathologist | 4308 Hanover Park Dr, Jacksonville, FL 32224-8602 | 2007-08-05 |
| 1932258555 | Melanie Jill O'brien | Social Worker | 4308 Hanover Park Dr, Jacksonville, FL 32224-8602 | 2007-01-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356974372 | Noelle Parker | Specialist/Technologist | 1 Unf Drivve, Jacksonville, FL 32224 | 2020-02-18 |
| 1124685102 | Charcy Rene Stiller | Specialist/Technologist | 1 Unf Dr., Jacksonville, FL 32224 | 2019-05-24 |
| 1265097513 | Mayo Clinic Jacksonville | Ambulance | 13970 Zumbro Dr, Jacksonville, FL 32224 | 2019-05-02 |
| 1639681471 | Brigantti Anesthesia & Spine Care | Clinic/Center | 1361 13th Ave South Suite #210, Jacksonville, FL 32224 | 2017-11-02 |
| 1093240061 | Beric Emilio Berlioz | Anesthesiology | 4500 San Pablo Rd S # J, Jacksonville, FL 32224 | 2017-04-26 |
| 1609240746 | Matthew James Dailey | Nurse Anesthetist, Certified Registered | 2500 San Pablo Rd S, Jacksonville, FL 32224 | 2015-11-29 |
| 1003299603 | Upscale Personal Care Home | Assisted Living Facility | 4375 Autumn River Road, Jacksonville, FL 32224 | 2015-07-01 |
| 1629459375 | Bellanid Fonseca | Social Worker | 3694 Summerlin Ln E, Jacksonville, FL 32224 | 2015-06-17 |
| 1164840500 | Nicholas Scotto | Physical Therapist | 11555 Central Pkwy Ste 1104, Jacksonville, FL 32224 | 2014-04-02 |
| 1497093454 | Quicker Care Urgent Care | Point of Service | 13770 Beach Blvd., Unit # 4, Jacksonville, FL 32224 | 2013-01-27 |
| Find all providers in zip 32224 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104436963 | Cassandra Hert | Developmental Therapist | 13738 Alesbury Ct, Jacksonville, FL 32224-2236 | 2020-08-06 |
| 1710543897 | Angela Marie Simons | Developmental Therapist | 14030 Ivylgail Dr N, Jacksonville, FL 32225-2024 | 2019-05-14 |
| 1861954950 | Darnise Lashelle Price | Developmental Therapist | 18 Woodbriar Dr, Jacksonville, AR 72076-5365 | 2019-04-05 |
| 1255804977 | Christina Maton | Developmental Therapist | 11041 Ridge Point Dr, Jacksonville, FL 32257-3717 | 2019-01-04 |
| 1811415847 | Kimberly Armstrong | Developmental Therapist | 1206 Turtle Creek Dr. S, Jacksonville, FL 32218 | 2017-08-30 |
| 1407395205 | Mary Christina Bush | Developmental Therapist | 1274 Surfway Ct, Jacksonville, FL 32233-2241 | 2017-02-14 |
| 1922554575 | Lavoris Andrew Mobley | Developmental Therapist | 9000 Cypress Green Drive, Jacksonville, FL 32256 | 2016-09-01 |
| 1861948481 | Nicole Gay | Developmental Therapist | 12276 San Jose Blvd, Ste 5, Jacksonville, FL 32223 | 2016-09-01 |
| 1134676711 | Katelyn Luksha | Developmental Therapist | 6867 Southpoiont Drive North, Jacksonville, FL 32216 | 2016-09-01 |
| 1780057794 | Nicole Terry | Developmental Therapist | 3610 N Ride Dr, Jacksonville, FL 32223-7489 | 2015-11-12 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32224 |
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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.