Organization Active NPI

Gilliam Solutions Group LLC

  • Behavior Analyst
  • Orange Park, FL
National Provider Identifier
1841753571
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
GILLIAM SOLUTIONS GROUP LLC
Practice address
1335 Kingsley Ave # 2472
Orange Park, FL 32073-4507
Phone
(904) 329-0028
NPI assigned
Apr 10, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Authorized official

Name
Alysia Gilliam, BCBA
Title
Owner
Phone
(904) 329-0028

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

1335 Kingsley Ave # 2472
Orange Park, FL 32073-4507

Mailing address

1335 Kingsley Ave # 2472
Orange Park, FL 32073-4507

Other identifiers 1

IdentifierTypeStateIssuer
019773100MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hello@alysiagilliam.com Direct

National Provider Directory

National Provider Directory

Locations

1335 Kingsley Ave
#2472
Orange Park, FL 32073
Phone (904) 329-0028

NPI Registry JSON

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554854400000",
    "number": "1841753571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 KINGSLEY AVE # 2472",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 KINGSLEY AVE # 2472",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734507",
            "telephone_number": "904-329-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GILLIAM SOLUTIONS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-10",
        "last_updated": "2019-04-10",
        "status": "A",
        "authorized_official_last_name": "GILLIAM",
        "authorized_official_first_name": "ALYSIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-329-0028",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019773100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hello@alysiagilliam.com",
            "affiliation": "N",
            "endpointDescription": "Admin Email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1335 Kingsley Ave # 2472",
            "city": "Orange Park",
            "state": "FL",
            "country_code": "US",
            "postal_code": "320734507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; 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.