Kristine Noer Peterson, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2016035945 Issued in MO

Practice address

1032 Crosswinds CT
Wentzville, MO 63385-4836

Phone

(636) 332-6000

NPI assigned

Sep 15, 2016

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 names 1

• Kristine Noer Makhamreh Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• South County Nursing Home, Inc.

  • Skilled Nursing Facility
  • Arnold, MO
  • NPI 1649312745
  NPD

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

{
    "created_epoch": "1473897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493164800000",
    "number": "1457809717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 CROSSWINDS CT",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633854836",
            "telephone_number": "636-332-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 CROSSWINDS CT",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633854836",
            "telephone_number": "636-332-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KRISTINE",
        "middle_name": "NOER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-15",
        "last_updated": "2017-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2016035945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "MAKHAMREH",
            "middle_name": "NOER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Fernando Perez-Magnelli, MD
• Laura G Perrino, P.T.
• Personal Touch Home Care of Mo, Inc.
• Elizabeth Peters, PTA
• Matthew Peters, LPC
• Patricia L Peterson
• Antonio Lawrence Petralia
• Christine Petty, LCSW
• Katelyn Pezzimenti, BCBA, LBA
• Phoenix Therapies, LLC

• Clinical Psychologist in Wentzville, MO
• Providers in Wentzville, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.

Verify at the official NPI Registry.