Individual provider Active NPI

Tori Joann Pattermann

  • Behavior Analyst
  • Fayetteville, AR
National Provider Identifier
1023655248
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
3155 N College Ave Ste 108
Fayetteville, AR 72703-3500
Phone
(479) 957-9121
Fax
(479) 777-9967
NPI assigned
Dec 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary
Behavior Technician 106S00000X

Addresses

Primary practice location

3155 N College Ave Ste 108
Fayetteville, AR 72703-3500

Mailing address

300 International Pkwy Ste 200
Lake Mary, FL 32746-5028
Phone (407) 915-7729

Other practice location 1

212 S Lincoln St Ste A
Lowell, AR 72745-9722
Phone (479) 770-0074

Other practice location 2

272 School Ave
West Fork, AR 72774-3124
Phone (479) 889-3349

Other identifiers 2

IdentifierTypeStateIssuer
273730706MedicaidAR
273986790MedicaidAR

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

Practice roles

OrganizationSpecialtyStatusNew patients
Friendship Community Care Inc. PastSince Jan 1, 2023 Accepting new patients
Aim Therapy, LLC PastSince Sep 20, 2020 Accepting new patients
Friendship Community Care PastSince Jan 1, 2023 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1575590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1023655248",
    "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": "407-915-7729",
            "fax_number": "407-588-6294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3155 N COLLEGE AVE STE 108",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727033500",
            "telephone_number": "479-957-9121",
            "fax_number": "479-777-9967"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 S Lincoln St Ste A",
            "address_purpose": "LOCATION",
            "city": "Lowell",
            "state": "AR",
            "postal_code": "727459722",
            "country_code": "US",
            "telephone_number": "479-770-0074",
            "fax_number": "479-770-0176",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "272 School Ave",
            "address_purpose": "LOCATION",
            "city": "West Fork",
            "state": "AR",
            "postal_code": "727743124",
            "country_code": "US",
            "telephone_number": "479-889-3349",
            "fax_number": "479-839-3752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTERMANN",
        "first_name": "TORI",
        "middle_name": "JOANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-06",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273730706",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273986790",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.