Active NPI
Petra E Peper, PHD
- Psychologist
- Phoenix, AZ
National Provider Identifier
1932324290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3469
- Practice address
- 4047 N 40TH PL
Phoenix, AZ 85018-5206 - Phone
- (602) 313-0927
- NPI assigned
- Apr 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3469 | AZ | Primary |
Addresses
Primary practice location
4047 N 40TH PL
Phoenix, AZ 85018-5206
Mailing address
PO Box 12216
Scottsdale, AZ 85267-2216
Phone (602) 313-0927
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3469 | Other | AZ | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2025 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3469 | AZ | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452038400000",
"number": "1932324290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12216",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852672216",
"telephone_number": "602-313-0927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4047 N 40TH PL",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850185206",
"telephone_number": "602-313-0927"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEPER",
"first_name": "PETRA",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-13",
"last_updated": "2016-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AZ",
"license": "3469",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "3469",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.