Active NPI
Taneka D Wilson
- Developmentally Disabled Services Day Training Agency
- Ocala, FL
National Provider Identifier
1952942401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmentally Disabled Services Day Training Agency
- License
- 690063196
- Practice address
- 3209 SW 34TH Avenue Cir
Ocala, FL 34474-3372 - Phone
- (352) 789-6795
- Fax
- (352) 789-6796
- NPI assigned
- Oct 7, 2019
- Last updated
- Oct 7, 2019
- 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 |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | 690063196 | FL | Primary |
Addresses
Primary practice location
3209 SW 34TH Avenue Cir
Ocala, FL 34474-3372
Mailing address
3209 SW 34TH Avenue Cir
Ocala, FL 34474-3372
Phone (352) 789-6795
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 690063196 | Medicaid | FL |
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 |
|---|---|---|---|
| 690063196 | FL | MD | Developmentally Disabled Services Day Training Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570406400000",
"number": "1952942401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3209 SW 34TH AVENUE CIR",
"city": "OCALA",
"state": "FL",
"postal_code": "344743372",
"telephone_number": "352-789-6795",
"fax_number": "352-789-6796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3209 SW 34TH AVENUE CIR",
"city": "OCALA",
"state": "FL",
"postal_code": "344743372",
"telephone_number": "352-789-6795",
"fax_number": "352-789-6796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "TANEKA",
"middle_name": "D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-07",
"last_updated": "2019-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": "FL",
"license": "690063196",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "690063196",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ocala, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.