Individual provider Active NPI

Rachel Marie Petmecky, BCABA

  • Assistant Behavior Analyst
  • Sugar Land, TX
National Provider Identifier
1790274157
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
0-16-7570 Issued in TX
Practice address
2515 Cordes Dr
Sugar Land, TX 77479-1386
Phone
(832) 358-2655
NPI assigned
May 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X 0-16-7570 TX Primary

Addresses

Primary practice location

2515 Cordes Dr
Sugar Land, TX 77479-1386

Mailing address

2515 Cordes Dr
Sugar Land, TX 77479-1386
Phone (832) 358-2655

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Institue for Special Needs Children, LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1790274157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 CORDES DR",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774791386",
            "telephone_number": "832-358-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 CORDES DR",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774791386",
            "telephone_number": "832-358-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETMECKY",
        "first_name": "RACHEL",
        "middle_name": "MARIE",
        "credential": "BCABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-01",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "TX",
            "license": "0-16-7570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.