Active NPI
Michele Lynn Peterson
- Behavior Analyst
- Belen, NM
National Provider Identifier
1659808129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 322 1/2 Desoto Ave
Belen, NM 87002-4538 - Phone
- (505) 235-5737
- NPI assigned
- May 16, 2017
- 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 Analyst | 103K00000X | Primary |
Addresses
Primary practice location
322 1/2 Desoto Ave
Belen, NM 87002-4538
Mailing address
322 1/2 Desoto Ave
Belen, NM 87002-4538
Phone (505) 235-5737
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 514714525 | Other | NM | NMDL |
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": "1494892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1659808129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "322 1/2 DESOTO AVE",
"city": "BELEN",
"state": "NM",
"postal_code": "870024538",
"telephone_number": "505-235-5737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "322 1/2 DESOTO AVE",
"city": "BELEN",
"state": "NM",
"postal_code": "870024538",
"telephone_number": "505-235-5737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "MICHELE",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-16",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NMDL",
"identifier": "514714525",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Belen, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.