Active NPI
Sheridan Fredericks
- Behavior Technician
- Lubbock, TX
National Provider Identifier
1366286247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 6434 98TH St Ste 100
Lubbock, TX 79424-5468 - Phone
- (866) 832-1708
- Fax
- (888) 789-4391
- NPI assigned
- Jun 24, 2024
- Sex
- Female
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
6434 98TH St Ste 100
Lubbock, TX 79424-5468
Mailing address
1013 S Highway 377
Pilot Point, TX 76258-4355
Phone (866) 832-1708
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Therapy, Inc. | Current | Accepting new patients | |
| Pediatric Therapy Incorporated | Past | Accepting new patients |
Locations
6434 98th St
Ste 100
Lubbock, TX 79424
Phone (866) 832-1708
Organizations & group practices 2
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.
-
- Pediatric Physical Therapist
- Paris, TX
- NPI 1255492864
-
- Home Health Agency
- Aubrey, TX
- NPI 1215354832
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719187200000",
"number": "1366286247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1013 S HIGHWAY 377",
"city": "PILOT POINT",
"state": "TX",
"postal_code": "762584355",
"telephone_number": "866-832-1708",
"fax_number": "888-789-4391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6434 98TH ST STE 100",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794245468",
"telephone_number": "866-832-1708",
"fax_number": "888-789-4391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERICKS",
"first_name": "SHERIDAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-24",
"last_updated": "2024-06-24",
"certification_date": "2024-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.