Individual provider Active NPI

Quantravius Earl Williams

  • Behavior Analyst
  • St Augustine, FL
National Provider Identifier
1972017770
Registry record updated Dec 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
2101 Arc Dr
St Augustine, FL 32084-0512
Phone
(904) 824-7249
Fax
(904) 824-7249
NPI assigned
Dec 1, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2017

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

2101 Arc Dr
St Augustine, FL 32084-0512

Mailing address

733 W 6TH St
Saint Augustine, FL 32084-3919
Phone (904) 377-4990

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": "1512086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512086400000",
    "number": "1972017770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 W 6TH ST",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320843919",
            "telephone_number": "904-377-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 ARC DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320840512",
            "telephone_number": "904-824-7249",
            "fax_number": "904-824-7249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "QUANTRAVIUS",
        "middle_name": "EARL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-01",
        "last_updated": "2017-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; 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.