Active NPI
Peter A Macmullan, PSY.D.
- Clinical Psychologist
- Augusta, ME
National Provider Identifier
1366568321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS888
- Practice address
- 1 VA Ctr
Togus VA Medical Center
Augusta, ME 04330-6719 - Phone
- (207) 623-8411
- NPI assigned
- Mar 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | PS888 | ME | Primary |
Addresses
Primary practice location
1 VA Ctr
Togus VA Medical Center
Augusta, ME 04330-6719
Mailing address
110 Christopher Rd
North Yarmouth, ME 04097-6733
Phone (207) 657-5564
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS888 | ME | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366568321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 CHRISTOPHER RD",
"city": "NORTH YARMOUTH",
"state": "ME",
"postal_code": "040976733",
"telephone_number": "207-657-5564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 VA CTR",
"address_2": "TOGUS VA MEDICAL CENTER",
"city": "AUGUSTA",
"state": "ME",
"postal_code": "043306719",
"telephone_number": "207-623-8411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACMULLAN",
"first_name": "PETER",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "ME",
"license": "PS888",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Augusta, ME
- Ashley Andrews Macdearmid, PA, ATC
- Machias River Family Psychiatry LLC
- Machias River Family Psychiatryllc
- Kylene Mackillop, MD
- Nicole Summers Macmillan, MS, OTR/L
- Vanessa Lynn Macoy, LCSW
- Melissa Ann Macphee, LCSW
- Maxwell Alexander Madden, LMSW, LCDC
- Paul Travis Maddocks, SLP
- Colleen Mairead Madigan, LCSW
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.