Active NPI
Tiffany Peterson
- Clinical Psychologist
- Florence, CO
National Provider Identifier
1467992164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP5008
- Practice address
- 5880 State Highway 67
Florence, CO 81226-9791 - Phone
- (719) 784-9464
- NPI assigned
- Feb 28, 2017
- Last updated
- Feb 28, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP5008 | MN | Primary |
| Clinical Psychologist | 103TC0700X | 36674 | TX |
Addresses
Primary practice location
5880 State Highway 67
Florence, CO 81226-9791
Mailing address
PO Box 8500
Florence, CO 81226-8500
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP5008 | MN | MD | Clinical Psychologist |
| 36674 | TX | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Federal Bureau of Prisons | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Prison Health Clinic/Center
- Florence, CO
- NPI 1538580774
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488240000000",
"number": "1467992164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8500",
"city": "FLORENCE",
"state": "CO",
"postal_code": "812268500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5880 STATE HIGHWAY 67",
"city": "FLORENCE",
"state": "CO",
"postal_code": "812269791",
"telephone_number": "719-784-9464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "TIFFANY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-28",
"last_updated": "2017-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP5008",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "36674",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florence, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.