Active NPI
Peter E Jaberg, PH.D.
- Psychologist
- Springfield, MO
National Provider Identifier
1104079425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2007028981
- Practice address
- 1322 S Campbell Ave
Springfield, MO 65807-1445 - Phone
- (417) 865-8943
- NPI assigned
- Oct 30, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2007028981 | MO | Primary |
Addresses
Primary practice location
1322 S Campbell Ave
Springfield, MO 65807-1445
Mailing address
773 Timber RDG
Nixa, MO 65714-8961
Phone (618) 203-1586
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)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225324800000",
"number": "1104079425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "773 TIMBER RDG",
"city": "NIXA",
"state": "MO",
"postal_code": "657148961",
"telephone_number": "618-203-1586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1322 S CAMPBELL AVE",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658071445",
"telephone_number": "417-865-8943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JABERG",
"first_name": "PETER",
"middle_name": "E",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-10-30",
"last_updated": "2008-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MO",
"license": "2007028981",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.