Active NPI
Tara Jade Peterslie, RBT
- Behavior Technician
- Omaha, NE
National Provider Identifier
1457061624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-245869
- Practice address
- 1299 Farnam St Ste 300
Omaha, NE 68102-1857 - Phone
- (402) 252-8181
- NPI assigned
- Nov 29, 2022
- 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 | RBT-22-245869 | NE | Primary |
Addresses
Primary practice location
1299 Farnam St Ste 300
Omaha, NE 68102-1857
Mailing address
1019 Turner Blvd Apt 2
Omaha, NE 68105-1961
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 |
|---|---|---|---|
| RBT-22-245869 | NE | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669680000000",
"number": "1457061624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1019 TURNER BLVD APT 2",
"city": "OMAHA",
"state": "NE",
"postal_code": "681051961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1299 FARNAM ST STE 300",
"city": "OMAHA",
"state": "NE",
"postal_code": "681021857",
"telephone_number": "402-252-8181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSLIE",
"first_name": "TARA",
"middle_name": "JADE",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-29",
"last_updated": "2022-11-29",
"certification_date": "2022-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NE",
"license": "RBT-22-245869",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.