Kenneth Michael Peters, M.A., SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA6156 Issued in FL

Practice address

790 NW 107TH Ave Ste 209
Miami, FL 33172-3158

Phone

(786) 512-4793

Fax

(786) 441-4413

NPI assigned

Sep 9, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1982072849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 NW 107TH AVE STE 209",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331723158",
            "telephone_number": "786-512-4793",
            "fax_number": "786-441-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 NW 107TH AVE STE 209",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331723158",
            "telephone_number": "786-512-4793",
            "fax_number": "786-441-4413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "KENNETH",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "M.A., SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-09",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA6156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raynel-Jan Peteros, DPT
• Adrienne K. Peters, M.ED.
• Ashley Peters, FNP
• Diane Peters, M.A.,CCC-SLP
• John M. Peters, D.O.
• Petersen Medical Corp.
• Melissa Petersen
• Paul Lewis Petersen, MD
• Amy Judith Peterson, B.S.W
• Catherine D Peterson, LCSW

• Speech-Language Pathologist in Miami, FL
• Providers in Miami, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.