Individual provider Active NPI

Cheryl Peterman

  • Speech-Language Pathologist
  • Dothan, AL
National Provider Identifier
1770014540
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
0649 Issued in AL
Practice address
2715 Flynn Rd
Dothan, AL 36303-1162
Phone
(334) 793-3102
NPI assigned
Mar 23, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 0649 AL Primary

Addresses

Primary practice location

2715 Flynn Rd
Dothan, AL 36303-1162

Mailing address

2715 Flynn Rd
Dothan, AL 36303-1162

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
0649ALMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dothan Houston County Mr Board Inc. Past Accepting new patients
Dothan Houston County Mental Retardation Board, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1770014540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 FLYNN RD",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 FLYNN RD",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031162",
            "telephone_number": "334-793-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERMAN",
        "first_name": "CHERYL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": "0649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.