Active NPI
Adiesha Williams
- Behavior Technician
- Cameron, NC
National Provider Identifier
1194569962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-302936
- Practice address
- 185 Mittie Haddock Dr
Cameron, NC 28326-9379 - Phone
- (910) 500-7783
- NPI assigned
- Jun 25, 2024
- Last updated
- Nov 5, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | NU | ||
| Behavior Technician | 106S00000X | RBT-23-302936 | TN | Primary |
Addresses
Primary practice location
185 Mittie Haddock Dr
Cameron, NC 28326-9379
Mailing address
5508 Ascent Drive
Hopemills, NC 28348
Phone (423) 497-9656
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-23-302936 | TN | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Autism Center | Behavior Technician | Current | Accepting new patients |
Locations
185 Mittie Haddock Dr
Cameron, NC 28326
Phone (910) 500-7783
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730764800000",
"number": "1194569962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5508 ASCENT DRIVE",
"city": "HOPEMILLS",
"state": "NC",
"postal_code": "28348",
"telephone_number": "423-497-9656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 MITTIE HADDOCK DR",
"city": "CAMERON",
"state": "NC",
"postal_code": "283269379",
"telephone_number": "910-500-7783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "ADIESHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-25",
"last_updated": "2024-11-05",
"certification_date": "2024-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TN",
"license": "RBT-23-302936",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cameron, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.