Individual provider Active NPI

Frederick Joseph Gilliard Jr., RBT

  • Behavior Analyst
  • Pensacola, FL
National Provider Identifier
1720568439
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
5154 Bayou Blvd
Pensacola, FL 32503-2102
Phone
(850) 416-7548
Fax
(850) 416-7776
NPI assigned
Aug 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

5154 Bayou Blvd
Pensacola, FL 32503-2102

Mailing address

5154 Bayou Blvd
Pensacola, FL 32503-2102
Phone (850) 416-7548

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": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1720568439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5154 BAYOU BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032102",
            "telephone_number": "850-416-7548",
            "fax_number": "850-416-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5154 BAYOU BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032102",
            "telephone_number": "850-416-7548",
            "fax_number": "850-416-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIARD",
        "first_name": "FREDERICK",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.