Active NPI
Ava Christine Cooreman, RBT
- Behavior Technician
- Colorado Springs, CO
National Provider Identifier
1841054095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 171100432
- Practice address
- Keystone Central 5526 N. Academy Blvd. Ste 109
Colorado Springs, CO 80918 - Phone
- (719) 301-5100
- NPI assigned
- Feb 8, 2024
- Sex
- Female
- Sole proprietor
- No
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 | 171100432 | CO | Primary |
Addresses
Primary practice location
Keystone Central 5526 N. Academy Blvd. Ste 109
Colorado Springs, CO 80918
Mailing address
Keystone Central 5526 N. Academy Blvd. Ste 109
Colorado Springs, CO 80918
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790211605 | Medicaid | CO |
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 |
|---|---|---|---|
| 171100432 | CO | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707350400000",
"number": "1841054095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "KEYSTONE CENTRAL 5526 N. ACADEMY BLVD. STE 109",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "KEYSTONE CENTRAL 5526 N. ACADEMY BLVD. STE 109",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80918",
"telephone_number": "719-301-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOREMAN",
"first_name": "AVA",
"middle_name": "CHRISTINE",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-08",
"last_updated": "2024-02-08",
"certification_date": "2024-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CO",
"license": "171100432",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1790211605",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.