Active NPI
Tamara Roberts, PH.D.
- Psychologist
- Louisville, KY
National Provider Identifier
1396758579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 129250
- Practice address
- 159 Saint Matthews Ave Ste 3
Louisville, KY 40207-3137 - Phone
- (502) 721-0435
- Fax
- (502) 721-0436
- NPI assigned
- Aug 15, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 129250 | KY | Primary |
Addresses
Primary practice location
159 Saint Matthews Ave Ste 3
Louisville, KY 40207-3137
Mailing address
159 Saint Matthews Ave Ste 3
Louisville, KY 40207-3137
Phone (502) 721-0435
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 129250 | KY | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peterson Psychological Services, PLLC | Psychologist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychologist
- Louisville, KY
- NPI 1255755120
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486944000000",
"number": "1396758579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "159 SAINT MATTHEWS AVE STE 3",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402073137",
"telephone_number": "502-721-0435",
"fax_number": "502-721-0436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "159 SAINT MATTHEWS AVE STE 3",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402073137",
"telephone_number": "502-721-0435",
"fax_number": "502-721-0436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "TAMARA",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-15",
"last_updated": "2017-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "KY",
"license": "129250",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.