Active NPI
Xzavion William Bard
- Behavior Analyst
- Snellville, GA
National Provider Identifier
1205573003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 3110 Gallery Walk
Snellville, GA 30039-4737 - Phone
- (404) 948-8914
- NPI assigned
- May 13, 2022
- Sex
- Male
- Sole proprietor
- No
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 Analyst | 103K00000X | Primary |
Addresses
Primary practice location
3110 Gallery Walk
Snellville, GA 30039-4737
Mailing address
3110 Gallery Walk
Snellville, GA 30039-4737
Phone (404) 948-8914
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 109480526-00 | Medicaid | GA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652400000000",
"number": "1205573003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3110 GALLERY WALK",
"city": "SNELLVILLE",
"state": "GA",
"postal_code": "300394737",
"telephone_number": "404-948-8914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3110 GALLERY WALK",
"city": "SNELLVILLE",
"state": "GA",
"postal_code": "300394737",
"telephone_number": "404-948-8914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARD",
"first_name": "XZAVION",
"middle_name": "WILLIAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-13",
"last_updated": "2022-05-13",
"certification_date": "2022-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "109480526-00",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Snellville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.