Active NPI
Kiadra Desiree Williams
- Behavior Technician
- Statesboro, GA
National Provider Identifier
1891676169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-24-343362
- Practice address
- 564 E Main St Apt 154
Statesboro, GA 30461-2575 - Phone
- (912) 221-5250
- NPI assigned
- Sep 11, 2025
- Sex
- Female
- Sole proprietor
- Yes
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-24-343362 | GA | Primary |
Addresses
Primary practice location
564 E Main St Apt 154
Statesboro, GA 30461-2575
Mailing address
2340 Southern Manor Rd
Metter, GA 30439-7613
Phone (912) 221-5250
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-24-343362 | GA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1757548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761264000000",
"number": "1891676169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2340 SOUTHERN MANOR RD",
"city": "METTER",
"state": "GA",
"postal_code": "304397613",
"telephone_number": "912-221-5250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "564 E MAIN ST APT 154",
"city": "STATESBORO",
"state": "GA",
"postal_code": "304612575",
"telephone_number": "912-221-5250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "KIADRA",
"middle_name": "DESIREE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-09-11",
"last_updated": "2025-10-24",
"certification_date": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "RBT-24-343362",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Statesboro, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.