Individual provider Active NPI

Sarah Michelle Peterson, RBT, BCBA

  • Behavior Analyst
  • Centennial, CO
National Provider Identifier
1770113219
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-24-70529 Issued in CO
Practice address
9000 E Nichols Ave Ste 100
Centennial, CO 80112-3429
Phone
(720) 706-3396
NPI assigned
Jan 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 1992372 CO
Behavior Analyst 103K00000X 1-24-70529 CO Primary

Addresses

Primary practice location

9000 E Nichols Ave Ste 100
Centennial, CO 80112-3429

Mailing address

9000 E Nichols Ave Ste 100
Centennial, CO 80112-3429
Phone (720) 706-3396

Other practice location 1

8002 E 50th Dr
Denver, CO 80238-3299
Phone (720) 961-3764

Other identifiers 1

IdentifierTypeStateIssuer
1992372OtherCORBT

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
1992372COMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Autism Behavioral Ventures LLC Behavior Analyst PastSince Jan 1, 2020 Accepting new patients
Soar Health, Inc. Behavior Analyst 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": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1770113219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 E NICHOLS AVE STE 100",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801123429",
            "telephone_number": "720-706-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 E NICHOLS AVE STE 100",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801123429",
            "telephone_number": "720-706-3396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8002 E 50th Dr",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802383299",
            "country_code": "US",
            "telephone_number": "720-961-3764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SARAH",
        "middle_name": "MICHELLE",
        "credential": "RBT, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CO",
            "license": "1992372",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CO",
            "license": "1-24-70529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RBT",
            "identifier": "1992372",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.