Active NPI
David Kim Peterson, LPC
- Professional Counselor
- Hot Springs, AR
National Provider Identifier
1497725899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- P8904003
- Practice address
- 125 Dons Way
Hot Springs, AR 71913-3423 - Phone
- (501) 624-7111
- Fax
- (501) 620-5109
- NPI assigned
- Jan 26, 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | P8904003 | AR | Primary |
Addresses
Primary practice location
125 Dons Way
Hot Springs, AR 71913-3423
Mailing address
125 Dons Way
Hot Springs, AR 71913
Phone (501) 620-5130
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 116399726 | Medicaid | AR | |
| 5T108 | Other | AR | BLUE CROSS & BLUE SHIELD |
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 |
|---|---|---|---|
| P8904003 | AR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229644800000",
"number": "1497725899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 DONS WAY",
"city": "HOT SPRINGS",
"state": "AR",
"postal_code": "71913",
"telephone_number": "501-620-5130",
"fax_number": "501-620-5109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 DONS WAY",
"city": "HOT SPRINGS",
"state": "AR",
"postal_code": "719133423",
"telephone_number": "501-624-7111",
"fax_number": "501-620-5109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "DAVID",
"middle_name": "KIM",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-26",
"last_updated": "2008-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AR",
"license": "P8904003",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "116399726",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS & BLUE SHIELD",
"identifier": "5T108",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hot Springs, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.