Active NPI
Peter Arden Grover, PH.D.
- Clinical Psychologist
- Milwaukie, OR
National Provider Identifier
1730260951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1163
- Practice address
- 10330 SE 32ND Ave
Suite 205
Milwaukie, OR 97222-6587 - Phone
- (503) 513-8950
- NPI assigned
- Oct 17, 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1163 | OR | Primary |
Addresses
Primary practice location
10330 SE 32ND Ave
Suite 205
Milwaukie, OR 97222-6587
Mailing address
PO Box 3158
Portland, OR 97208-3158
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500619622 | Medicaid | OR | |
| P01046663 | Other | OR | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1163 | OR | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Recovery Works NW LLC | Current | Accepting new patients | |
| Recovery Works NW LLC | Past | Accepting new patients |
Locations
173 NE 102nd Ave
Portland, OR 97220
Phone (503) 252-5100
12540 SW Main St
Ste 202
Tigard, OR 97223
Phone (503) 906-9995
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Tigard, OR
- NPI 1083010094
-
- Multi-Specialty Clinic/Center
- Portland, OR
- NPI 1871264416
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351641600000",
"number": "1730260951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3158",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10330 SE 32ND AVE",
"address_2": "SUITE 205",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "972226587",
"telephone_number": "503-513-8950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROVER",
"first_name": "PETER",
"middle_name": "ARDEN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2012-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "1163",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500619622",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P01046663",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukie, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.