Jacqueline Rose Pfeifer, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

866 Issued in KS

Practice address

3515 S 4TH St
Professional Association
Leavenworth, KS 66048

Phone

(913) 651-8415

Fax

(913) 772-8580

NPI assigned

Sep 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Frederick J Tirrell PHD Professional AssociationGroup PAC ID 8224017157, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Frederick J Tirrell PHD Professional Association

  • Psychologist
  • Leavenworth, KS
  • NPI 1013076215
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710082078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18955 WEST 116TH ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "66061",
            "telephone_number": "913-888-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 S 4TH ST",
            "address_2": "PROFESSIONAL ASSOCIATION",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "66048",
            "telephone_number": "913-651-8415",
            "fax_number": "913-772-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFEIFER",
        "first_name": "JACQUELINE",
        "middle_name": "ROSE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "866",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "R0407",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "060779",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD GR",
            "identifier": "004517",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS CITY BLUE CROSS BL",
            "identifier": "22447022",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1049473",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7154171",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth Perdue, APRN
• Rachel Petersen
• Thuy Le Petersen, PAC
• Jasmine Reshawn Petr
• Mary Cecilia Petree, BSN
• Quinton Pfrimmer
• Patricia Lynn Phillips, CTRS, CADCIII
• Pierre W Keitges MD PC
• Megan Jane Pilcher, ATC
• Frank Piper Jr., MS, MPAS, PA-C

• Psychologist in Leavenworth, KS
• Providers in Leavenworth, KS by specialty
• Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.