Daivon Maleke Wilson

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1619 Collins Rd NW Ste 500
Kennesaw, GA 30152-8237

Phone

(470) 531-0430

NPI assigned

Jul 28, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1760163109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 INTERNATIONAL PKWY STE 200",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465028",
            "telephone_number": "866-610-0850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 COLLINS RD NW STE 500",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301528237",
            "telephone_number": "470-531-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DAIVON",
        "middle_name": "MALEKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Kay Willis, D.C.
• William N Willis, D.C.
• Lori Brazell Wills, ED.S., CCC-SLP
• Ashley Wilson, PTA
• Bradley Neal Wilson, DC
• Jesceria Wilson
• Katisha L Wilson, PHARMD
• Suzette Karen Wilson, CMA,PCT,LMT
• Chassity Marie Wiltz
• Summer Maxine Wisehart, PHARM D

• Behavior Technician in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Behavior Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; 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.