Active NPI
Ayla Nichole Blackwelder
- Behavior Technician
- Viera, FL
National Provider Identifier
1215436779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 5500 Murrell Rd Ste 100
Viera, FL 32940-6700 - Phone
- (321) 426-7759
- NPI assigned
- Feb 9, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
5500 Murrell Rd Ste 100
Viera, FL 32940-6700
Mailing address
175 Middle St Unit 1201
Lake Mary, FL 32746-3625
Phone (866) 610-0580
Other names 1
- Ayla Nichole Williams
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": "1518134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611705600000",
"number": "1215436779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 MIDDLE ST UNIT 1201",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327463625",
"telephone_number": "866-610-0580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5500 MURRELL RD STE 100",
"city": "VIERA",
"state": "FL",
"postal_code": "329406700",
"telephone_number": "321-426-7759"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKWELDER",
"first_name": "AYLA",
"middle_name": "NICHOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-09",
"last_updated": "2021-01-27",
"certification_date": "2021-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AYLA",
"last_name": "WILLIAMS",
"middle_name": "NICHOLE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Viera, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.