Active NPI
William Christian Conway
- Behavior Technician
- Jacksonville, FL
National Provider Identifier
1689339939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-21-177740
- Practice address
- 4310 Barkoskie Rd
Jacksonville, FL 32258-1422 - Phone
- (904) 379-6045
- NPI assigned
- Nov 2, 2021
- 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 Technician | 106S00000X | RBT-21-177740 | FL | Primary |
Addresses
Primary practice location
4310 Barkoskie Rd
Jacksonville, FL 32258-1422
Mailing address
190 Chelsea St Apt 214
Jacksonville, FL 32204-2190
Phone (904) 236-1773
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | gtbjax.org |
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-21-177740 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Growing Together ABA | Behavior Technician | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635811200000",
"number": "1689339939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 CHELSEA ST APT 214",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322042190",
"telephone_number": "904-236-1773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4310 BARKOSKIE RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322581422",
"telephone_number": "904-379-6045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONWAY",
"first_name": "WILLIAM",
"middle_name": "CHRISTIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-02",
"last_updated": "2021-11-02",
"certification_date": "2021-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-21-177740",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "gtbjax.org",
"affiliation": "N",
"address_1": "4310 Barkoskie Rd",
"city": "Jacksonville",
"state": "FL",
"country_code": "US",
"postal_code": "322581422",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.