Peter John Thaxter, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

0810006004 Issued in VA

Practice address

510 Princess Anne St Ste 102
Fredericksburg, VA 22401-6077

Phone

(540) 698-0003

NPI assigned

Jun 25, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Center for Psychological Assessment and Consultation PC

  • Psychologist
  • Fredericksburg, VA
  • NPI 1437688546
  NPD (past)

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1174018980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8931 QUARRY RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201105160",
            "telephone_number": "703-969-4539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 PRINCESS ANNE ST STE 102",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224016077",
            "telephone_number": "540-698-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAXTER",
        "first_name": "PETER",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "VA",
            "license": "0810006004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tedla T Tessema, MD
• Alyssa Testa, ATC, LAT, PES
• Anne Tetor, LPC
• Whitney Alphonsus Tetor, BCBA, LBA
• Janeen Renee Thalman, RPH
• THD Medical Hair Rejuvenation Clinic
• The Arc of Rappahannock, Inc.
• The Belonging, LLC
• The Center for Orthopedics, Inc.
• The Children'S Clinic of Fredericksburg, PC

• Clinical Child & Adolescent Psychologist in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Clinical Child & Adolescent Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; 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.