Peggy A Keilman, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

300 Issued in NM

Practice address

4216 Balloon Park Rd NE
Albuquerque, NM 87109-5801

Phone

(505) 344-5470

NPI assigned

Jan 27, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cooperative Educational Services

  • Local Education Agency (LEA)
  • Albuquerque, NM
  • NPI 1720132707
  NPD (past)

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

{
    "created_epoch": "1169856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1275689515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 WALDEN RD",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870488379",
            "telephone_number": "505-890-4239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4216 BALLOON PARK RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871095801",
            "telephone_number": "505-344-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEILMAN",
        "first_name": "PEGGY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. ED,LEVEL 3A,TYPE906",
            "identifier": "206038",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "S3174",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Margaret Keetso, D.O.M.
• Shelby L Keffeler, COTA/L
• Ryan Keffer
• Dennis Bernard Kehoe, O.D.
• Sandra Kehoe
• Jeanmarie Keim, PH.D.,ABPP
• Diane Keister, PHD
• Gerrel Keith-Davis
• Peter C Keith, PTA
• Samual Keith, MD

• Clinical Psychologist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Psychologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.