John Peterson III

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

610 Main St
Lafayette, IN 47901-1451

Phone

(765) 423-2638

Fax

(765) 742-4196

NPI assigned

Feb 5, 2018

Sex

Male

Sole proprietor

No

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 IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Oaks Health IncGroup PAC ID 7315927563, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Valley Oaks Health Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lafayette, IN
  • NPI 1689629990
  Medicare reassignment Care Compare group NPD
• Valley Oaks Health Inc

  • Federally Qualified Health Center (FQHC)
  • Lafayette, IN
  • NPI 1134901135
  NPD

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

{
    "created_epoch": "1517788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517788800000",
    "number": "1992204044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 MAIN ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479011451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 MAIN ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479011451",
            "telephone_number": "765-423-2638",
            "fax_number": "765-742-4196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-05",
        "last_updated": "2018-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pestle Chiropractic & Sports Performance
• Chris Lynn Pestle, D.C.
• Lynn Arlen Pestle, DDS MS
• Peter Desmangles Counseling LLC
• Jeanne Yong-Tai Peterson, PHARMD
• Mark P Peterson, MD
• Stephen Peterson, LCSW,LCAC
• Donna Jean Petro
• Thomas Petry, MD
• Ashley Pezzarossi, RBT

• Mental Health Counselor in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2018; 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.
• 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.