Individual provider Active NPI

Christina Peterman

  • Behavior Analyst
  • Durant, OK
National Provider Identifier
1972347649
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
7705 Issued in TX
Practice address
372 Bryan Dr Ste 112
Durant, OK 74701-3466
Phone
(903) 444-0910
NPI assigned
Jun 19, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 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
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 7705 TX Primary

Addresses

Primary practice location

372 Bryan Dr Ste 112
Durant, OK 74701-3466

Mailing address

718 US Highway 82 E
Sherman, TX 75090-0528
Phone (903) 818-7665

Other practice location 1

718 US Highway 82 E
Sherman, TX 75090-0528
Phone (903) 818-7665

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
7705TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Prince ABA Consulting Behavior Analyst CurrentSince Nov 3, 2024 Accepting new patients

Locations

372 Bryan Dr
Ste 112
Durant, OK 74701
Phone (903) 444-0910

718 US Highway 82 E
Sherman, TX 75090
Phone (903) 444-0910

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1972347649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 US HIGHWAY 82 E",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750900528",
            "telephone_number": "903-818-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "372 BRYAN DR STE 112",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747013466",
            "telephone_number": "903-444-0910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "718 US Highway 82 E",
            "address_purpose": "LOCATION",
            "city": "Sherman",
            "state": "TX",
            "postal_code": "750900528",
            "country_code": "US",
            "telephone_number": "903-818-7665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERMAN",
        "first_name": "CHRISTINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "7705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durant, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.