Active NPI
Sharla Nicole Peterson, DSW
- Social Worker
- Waco, TX
National Provider Identifier
1689193930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 61825
- Practice address
- 4800 Memorial Dr
Waco, TX 76711-1329 - Phone
- (254) 297-3000
- NPI assigned
- Sep 18, 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 61825 | TX | Primary |
Addresses
Primary practice location
4800 Memorial Dr
Waco, TX 76711-1329
Mailing address
207 Stone Creek Ridge Dr
MC Gregor, TX 76657-4158
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 |
|---|---|---|---|
| 61825 | TX | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505692800000",
"number": "1689193930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 STONE CREEK RIDGE DR",
"city": "MC GREGOR",
"state": "TX",
"postal_code": "766574158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 MEMORIAL DR",
"city": "WACO",
"state": "TX",
"postal_code": "767111329",
"telephone_number": "254-297-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "SHARLA",
"middle_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "DSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-18",
"last_updated": "2017-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TX",
"license": "61825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.