NPIMap

Organization Active NPI

Red River Behavioral Specialists LLC

  • Behavior Analyst
  • Oklahoma City, OK
National Provider Identifier
1730692906
Registry record updated Nov 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-13-15033 Issued in OK
Legal business name
RED RIVER BEHAVIORAL SPECIALISTS LLC
Practice address
5737 NW 132ND St
Oklahoma City, OK 73142-4437
Phone
(661) 714-8068
NPI assigned
Nov 9, 2017
Last updated
Nov 9, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2017

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

Authorized official

Name
Dr. Sean Patrick Peterson, PHD, BCBA
Title
Owner
Phone
(661) 714-8068

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-13-15033 OK Primary

Addresses

Primary practice location

5737 NW 132ND St
Oklahoma City, OK 73142-4437

Mailing address

PO Box 720070
Oklahoma City, OK 73172-0070

Other identifiers 1

IdentifierTypeStateIssuer
1-13-15033OtherOKLBA

National Provider Directory

National Provider Directory

Locations

5737 NW 132nd St
Oklahoma City, OK 73142
Phone (661) 714-8068

NPI Registry JSON

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510185600000",
    "number": "1730692906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 720070",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731720070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5737 NW 132ND ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731424437",
            "telephone_number": "661-714-8068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED RIVER BEHAVIORAL SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-09",
        "last_updated": "2017-11-09",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-714-8068",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OK",
            "license": "1-13-15033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LBA",
            "identifier": "1-13-15033",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.