NPIMap

Organization Active NPI

Pediatric Action Therapy, LLC

  • Behavior Analyst
  • Boerne, TX
National Provider Identifier
1477875656
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1096577
Legal business name
PEDIATRIC ACTION THERAPY, LLC
Practice address
12 Der Flugplatz
Boerne, TX 78006-8661
Phone
(954) 540-1360
Fax
(830) 755-6525
NPI assigned
Feb 16, 2010
Last updated
Jan 18, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Authorized official

Name
Ms. Diana Marcela Barrera, MOT, OTR, BCBA, C/NDNPI 1033296413
Title
Executive Director
Phone
(954) 540-1360

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 1096577 Primary
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X 111734 TX
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

12 Der Flugplatz
Boerne, TX 78006-8661

Mailing address

12 Der Flugplatz
Boerne, TX 78006-8661
Phone (954) 540-1360

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1266278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1477875656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 DER FLUGPLATZ",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780068661",
            "telephone_number": "954-540-1360",
            "fax_number": "830-755-6525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 DER FLUGPLATZ",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780068661",
            "telephone_number": "954-540-1360",
            "fax_number": "830-755-6525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ACTION THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-16",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "BARRERA",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "MARCELA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "954-540-1360",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MOT, OTR, BCBA, C/ND"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1096577",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "111734",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.