Active NPI
Edward Thomas Peteroy
- Clinical Psychologist
- Colorado Springs, CO
National Provider Identifier
1891891131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 970
- Practice address
- 1935 Dominion Way
Suite A102
Colorado Springs, CO 80918-1464 - Phone
- (719) 599-7882
- Fax
- (719) 598-1437
- NPI assigned
- Sep 15, 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 | 970 | CO | Primary |
Addresses
Primary practice location
1935 Dominion Way
Suite A102
Colorado Springs, CO 80918-1464
Mailing address
PO Box 1562
Colorado Springs, CO 80901-1562
Phone (719) 599-7882
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 970 | CO | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Patricia E. Pirrello, PH.D., P.C. | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Psychologist
- Colorado Springs, CO
- NPI 1699089284
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891891131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1562",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809011562",
"telephone_number": "719-599-7882",
"fax_number": "719-598-1437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1935 DOMINION WAY",
"address_2": "SUITE A102",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809181464",
"telephone_number": "719-599-7882",
"fax_number": "719-598-1437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETEROY",
"first_name": "EDWARD",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "970",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.