Brandon L Peters, CDCA, QMHS

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

CDCA.180157 Issued in OH

Practice address

700 Park Ave
Ironton, OH 45638-1502

Phone

(740) 532-1613

NPI assigned

May 16, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1942947544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 108",
            "city": "IRONTON",
            "state": "OH",
            "postal_code": "456380108",
            "telephone_number": "740-532-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 PARK AVE",
            "city": "IRONTON",
            "state": "OH",
            "postal_code": "456381502",
            "telephone_number": "740-532-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "BRANDON",
        "middle_name": "L",
        "credential": "CDCA, QMHS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-16",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.180157",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": "CDCA.180157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0487206",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alisha Kar Perry
• Amity Perry
• Jason L Perry, CDCA
• Jodie E Perry, CDCA
• Billie Jo Persinger
• Kendra Peters, CDCA
• Anthony Ray Pettry
• Jaimie R Phillips, LISW
• Tonya Phillips
• Phoenix Center, Inc.

• Case Manager/Care Coordinator in Ironton, OH
• Providers in Ironton, OH by specialty
• Case Manager/Care Coordinator in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.