Individual provider Active NPI

Joseph Masterpool, RBT

  • Behavior Technician
  • Colorado Springs, CO
National Provider Identifier
1700393253
Registry record updated Jan 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
16-23832 Issued in CO
Practice address
685 Citadel Dr E Ste 345
Colorado Springs, CO 80909-5326
Phone
(940) 368-7105
Fax
(719) 638-8115
NPI assigned
Jan 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 16-23832 CO Primary

Addresses

Primary practice location

685 Citadel Dr E Ste 345
Colorado Springs, CO 80909-5326

Mailing address

PO Box 76510
Colorado Springs, CO 80970-6510
Phone (940) 368-7105

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

LicenseStateTypeSpecialty
16-23832COMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Potential Behavior & Wellness LLC PastSince Jun 27, 2021 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/980/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1515110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515110400000",
    "number": "1700393253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 76510",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809706510",
            "telephone_number": "940-368-7105",
            "fax_number": "719-638-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 CITADEL DR E STE 345",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095326",
            "telephone_number": "940-368-7105",
            "fax_number": "719-638-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTERPOOL",
        "first_name": "JOSEPH",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-05",
        "last_updated": "2018-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CO",
            "license": "16-23832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2018; 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.