Active NPI
Cheyenne Peconge
- Behavior Technician
- Fort Wayne, IN
National Provider Identifier
1841005766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-24-327478
- Practice address
- 6506 Covington Rd
Fort Wayne, IN 46804-7349 - Phone
- (260) 257-1735
- NPI assigned
- Feb 10, 2025
- Last updated
- Feb 10, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-24-327478 | IN | Primary |
Addresses
Primary practice location
6506 Covington Rd
Fort Wayne, IN 46804-7349
Mailing address
120 E Market St
Indianapolis, IN 46204-3250
Phone (404) 400-5004
Other practice location 1
13025 McDuffee Rd
Churubusco, IN 46723-9003
Phone (260) 246-3756
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-24-327478 | IN | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739145600000",
"number": "1841005766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 E MARKET ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462043250",
"telephone_number": "404-400-5004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6506 COVINGTON RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468047349",
"telephone_number": "260-257-1735"
}
],
"practiceLocations": [
{
"address_1": "13025 McDuffee Rd",
"address_purpose": "LOCATION",
"city": "Churubusco",
"state": "IN",
"postal_code": "467239003",
"country_code": "US",
"telephone_number": "260-246-3756",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PECONGE",
"first_name": "CHEYENNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-02-10",
"last_updated": "2025-02-10",
"certification_date": "2025-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IN",
"license": "RBT-24-327478",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.