Active NPI
Peter G Levine, PHD
- Clinical Psychologist
- Longmont, CO
National Provider Identifier
1306948401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- CO2011
- Practice address
- 709 Kimbark St
Longmont, CO 80501 - Phone
- (303) 678-7455
- Fax
- (303) 772-3887
- NPI assigned
- Sep 1, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | CO2011 | CO | Primary |
Addresses
Primary practice location
709 Kimbark St
Longmont, CO 80501
Mailing address
709 Kimbark St
Longmont, CO 80501
Phone (303) 678-7455
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16607376 | Medicaid | CO |
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, Doctor of Engineering
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CO2011 | CO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194307200000",
"number": "1306948401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 KIMBARK ST",
"city": "LONGMONT",
"state": "CO",
"postal_code": "80501",
"telephone_number": "303-678-7455",
"fax_number": "303-772-3887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "709 KIMBARK ST",
"city": "LONGMONT",
"state": "CO",
"postal_code": "80501",
"telephone_number": "303-678-7455",
"fax_number": "303-772-3887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVINE",
"first_name": "PETER",
"middle_name": "G",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-01",
"last_updated": "2007-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "CO2011",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "16607376",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Longmont, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.