Active NPI
Ashley Gilliam
- Behavior Technician
- Kissimmee, FL
National Provider Identifier
1306449756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1319 E Osceola Pkwy
Kissimmee, FL 34744-1606 - Phone
- (689) 837-2423
- NPI assigned
- Nov 18, 2020
- Last updated
- Nov 2, 2022
- 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 | NU | Primary |
Addresses
Primary practice location
1319 E Osceola Pkwy
Kissimmee, FL 34744-1606
Mailing address
2640 Willow Glen Cir
Kissimmee, FL 34744-5473
Phone (407) 785-9312
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 108881900 | 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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Breakthrough Behavior, LLC | 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, 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": "1605657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667347200000",
"number": "1306449756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2640 WILLOW GLEN CIR",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347445473",
"telephone_number": "407-785-9312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1319 E OSCEOLA PKWY",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347441606",
"telephone_number": "689-837-2423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIAM",
"first_name": "ASHLEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-18",
"last_updated": "2022-11-02",
"certification_date": "2022-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "108881900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.