F Tom Peterson, EDD LICENSE PSYCHOLO

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

119 Issued in MT

Practice address

18 N 8TH Street
#3
Miles City, MT 59301-0176

Phone

(406) 232-1595

Fax

(406) 232-1595

NPI assigned

Oct 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Peterson Psychological Services, Inc

  • Clinical Child & Adolescent Psychologist
  • Miles City, MT
  • NPI 1679812937
  Authorized official Same address or phone
• Eastern Montana Community Mental Health Center

  • Clinic/Center
  • Miles City, MT
  • NPI 1992786784
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033295712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 176",
            "address_2": "PETERSON PSYCHOLOGICAL SERVICES",
            "city": "MILES CITY",
            "state": "MT",
            "postal_code": "593010176",
            "telephone_number": "406-232-1595",
            "fax_number": "406-232-1595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 N 8TH STREET",
            "address_2": "#3",
            "city": "MILES CITY",
            "state": "MT",
            "postal_code": "593010176",
            "telephone_number": "406-232-1595",
            "fax_number": "406-232-1595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "F",
        "middle_name": "TOM",
        "name_prefix": "Dr.",
        "credential": "EDD LICENSE PSYCHOLO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MT",
            "license": "119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD/BC",
            "identifier": "5053",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "493389",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Asta Paulson
• Samantha Paxson, LCPC
• Pendelton House Assisted Living
• Paula Ellen Petersen, AU
• Peterson Psychological Services, Inc
• Caleb Wayde Petross
• Patricia June Pezzarossi, M.D.
• Paula L Plog, PA-C
• Angela Carrie Ponessa
• Cody Elizabeth Portwine-Kinzer, LCSW

• Clinical Psychologist in Miles City, MT
• Providers in Miles City, MT by specialty
• Clinical Psychologist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.