Peter James Ippoliti, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS917 Issued in ME

Practice address

4 Union St
Suite 25
Bangor, ME 04401

Phone

(207) 942-5656

NPI assigned

Mar 31, 2008

Last updated

May 5, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Northeast Occupational Exchange, Inc

  • Psychologist
  • Bangor, ME
  • NPI 1427002138
  NPD (past)

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209945600000",
    "number": "1649442633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 UNION ST",
            "address_2": "SUITE 25",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "04401",
            "telephone_number": "207-942-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 UNION ST",
            "address_2": "SUITE 25",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "04401",
            "telephone_number": "207-942-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IPPOLITI",
        "first_name": "PETER",
        "middle_name": "JAMES",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-31",
        "last_updated": "2008-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "PS917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillian Mary Beal Ingerson, LMT
• Diana Mary Inkova, CADC
• Insight-Premier Health LLC (RAYUS Radiology Bangor)
• Integrated Osteoporosis Clinic
• Invest in You Counseling, LLC
• Cynthia Iradukunda, MD
• Julie Irick, NNP
• Jane Marie Irish, LADC
• Louis Jordan Irwin, M.D.
• Leah C Isaacson, LMSW-CC

• Clinical Psychologist in Bangor, ME
• Providers in Bangor, ME by specialty
• Clinical Psychologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.

Verify at the official NPI Registry.