Individual provider Active NPI

Christine Ann Roeper, BCBA

  • Behavior Analyst
  • Lakeland, FL
National Provider Identifier
1265842249
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-21-47769 Issued in FL
Practice address
1382 Heritage Landings Dr
Lakeland, FL 33805-4602
Phone
(727) 267-4699
NPI assigned
Apr 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X 0-16-7539 FL
Other Technician 247200000X
Behavior Analyst 103K00000X 1-21-47769 FL Primary

Addresses

Primary practice location

1382 Heritage Landings Dr
Lakeland, FL 33805-4602

Mailing address

1382 Heritage Landings Dr
Lakeland, FL 33805-4602
Phone (727) 267-4699

Other identifiers 1

IdentifierTypeStateIssuer
020207400MedicaidFL

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": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1265842249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1382 HERITAGE LANDINGS DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054602",
            "telephone_number": "727-267-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1382 HERITAGE LANDINGS DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054602",
            "telephone_number": "727-267-4699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEPER",
        "first_name": "CHRISTINE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-30",
        "last_updated": "2022-10-28",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": "0-16-7539",
            "primary": false
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-21-47769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020207400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.