NPIMap

Organization Active NPI

Kevin H. Peterson

  • Psychologist
  • Cumberland, MD
National Provider Identifier
1508048554
Registry record updated May 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
02746 Issued in MD
Legal business name
KEVIN H. PETERSON
Practice address
31 Baltimore St
Suite 103
Cumberland, MD 21502-3072
Phone
(301) 759-3360
Fax
(301) 759-3360
NPI assigned
Dec 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kevin Howard Peterson, ED.DNPI 1053527895
Title
President
Phone
(301) 759-3360

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 02746 MD Primary

Addresses

Primary practice location

31 Baltimore St
Suite 103
Cumberland, MD 21502-3072

Mailing address

12517 Ellis Rd NE
Cumberland, MD 21502-6876
Phone (301) 759-3360

National Provider Directory

National Provider Directory

Locations

31 Baltimore St
Ste 103
Cumberland, MD 21502
Phone (301) 759-3360

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243468800000",
    "number": "1508048554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12517 ELLIS RD NE",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215026876",
            "telephone_number": "301-759-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 BALTIMORE ST",
            "address_2": "SUITE 103",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215023072",
            "telephone_number": "301-759-3360",
            "fax_number": "301-759-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN H. PETERSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-01",
        "last_updated": "2009-05-28",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-759-3360",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MD",
            "license": "02746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2009; 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.