Active NPI
Kayla Williams, RBT
- Behavior Technician
- Fort Walton Beach, FL
National Provider Identifier
1053974527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-19-83995
- Practice address
- 419 Racetrack Rd NW
Fort Walton Beach, FL 32547-4612 - Phone
- (850) 864-2273
- Fax
- (850) 862-6270
- NPI assigned
- Apr 19, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-19-83995 | FL | Primary |
Addresses
Primary practice location
419 Racetrack Rd NW
Fort Walton Beach, FL 32547-4612
Mailing address
2104 Lewis Turner Blvd
Fort Walton Beach, FL 32547-1316
Phone (850) 862-3728
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RBT-19-83995 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-19-83995 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Complete Rehabilitation Services, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Speech-Language Assistant
- Fort Walton Beach, FL
- NPI 1356446546
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555632000000",
"number": "1053974527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2104 LEWIS TURNER BLVD",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325471316",
"telephone_number": "850-862-3728",
"fax_number": "850-862-6270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "419 RACETRACK RD NW",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325474612",
"telephone_number": "850-864-2273",
"fax_number": "850-862-6270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "KAYLA",
"credential": "RBT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-19",
"last_updated": "2019-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-19-83995",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "RBT-19-83995",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Walton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.