Gail Peterson, PH.D.

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

071-002561 Issued in IL

Practice address

1400 N Wood Rd
Milwood Executive Suites
Murphysboro, IL 62966-6290

Phone

(618) 529-4988

Fax

(618) 351-1419

NPI assigned

Jan 20, 2006

Last updated

Jul 3, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Burke Behavioral Health, LLC

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  • Carbondale, IL
  • NPI 1972780880
  NPD (past)
• Holistic Healing Arts, LLC

  • Family Medicine Physician
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  • NPI 1346332467
  NPD (past)

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372809600000",
    "number": "1629058904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 443",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629030443",
            "telephone_number": "618-529-4988",
            "fax_number": "618-351-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N WOOD RD",
            "address_2": "MILWOOD EXECUTIVE SUITES",
            "city": "MURPHYSBORO",
            "state": "IL",
            "postal_code": "629666290",
            "telephone_number": "618-529-4988",
            "fax_number": "618-351-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "GAIL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-20",
        "last_updated": "2013-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "IL",
            "license": "071-002561",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MO",
            "license": "2006006592",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE MEDICAL PLANS",
            "identifier": "27485",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD",
            "identifier": "03972011",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK PROVIDER #",
            "identifier": "126480",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dana Oberg, NURSE PRACTITIONER
• Gail F Orr, RPH
• Prativa Pandey, MD
• Daniel R Parmley, D.D.S.
• Mary Frances Paskert, LCSW
• Phil's Prescription Drugs, Inc. (The Medicine Shoppe)
• Joseph G Pickard, PHD, LCSW
• Donald W Porter, D.O.
• Molly Quinn, LCSW
• Kathy Lynn Ragan, LPN

• Cognitive & Behavioral Psychologist in Murphysboro, IL
• Providers in Murphysboro, IL by specialty
• Cognitive & Behavioral Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; 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.