Individual provider Active NPI

Peter Greg Sprengelmeyer, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Eugene, OR
National Provider Identifier
1114095700
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
1395 Issued in OR
Practice address
315 W Broadway
Eugene, OR 97401-8311
Phone
(541) 743-4340
Fax
(541) 743-4369
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 1395 OR Primary

Addresses

Primary practice location

315 W Broadway
Eugene, OR 97401-8311

Mailing address

315 W Broadway
Eugene, OR 97401-8311
Phone (541) 743-4340

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1395ORMDNaturopath

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114095700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W BROADWAY",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018311",
            "telephone_number": "541-743-4340",
            "fax_number": "541-743-4369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W BROADWAY",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018311",
            "telephone_number": "541-743-4340",
            "fax_number": "541-743-4369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRENGELMEYER",
        "first_name": "PETER",
        "middle_name": "GREG",
        "name_prefix": "Mr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "OR",
            "license": "1395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.