ROBERTA J PEREGRINE (NPI# 1134110893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134110893 |
| Entity Type | Individual |
| Full Name | ROBERTA J PEREGRINE |
| Practice Address |
2602 Frederick Ave Ste A Saint Joseph MO 64506-2840 |
| Mailing Address |
2602 Frederick Ave Ste A Saint Joseph MO 64506-2847 |
| Practice Telephone | 8163878858 |
| Practice Fax Number | 8163878858 |
| Mailing Telephone | 8163878858 |
| Mailing Fax Number | 8163878858 |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2008-03-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224P00000X | Prosthetist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | BLUECROSSBLUESHIELD | 27826022 | 01 |
| Street Address |
2602 FREDERICK AVE STE A |
| City | SAINT JOSEPH |
| State | MO |
| Zip Code | 64506-2840 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750552667 | Roberta J Peregrine | Prosthetic/Orthotic Supplier | 2602 Frederick Ave, Ste A, Saint Joseph, MO 64506-2840 | 2008-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700484250 | Americare At Field Pointe LLC | Assisted Living Facility | 5002 Gene Field Road, St Joseph, MO 64506 | 2020-10-15 |
| 1669086609 | Phuc Vo | Pharmacist | 4022 N Belt Hyw, Saint Joseph, MO 64506 | 2020-09-08 |
| 1104450675 | Hughes Acupuncture LLC | Acupuncturist | 1918 North Belt Highway, St Joseph, MO 64506 | 2020-02-24 |
| 1306323316 | Camilla Allison Walling | Nurse Practitioner | 1009 West St. Maartens Drive Suite F, Saint Joseph, MO 64506 | 2018-07-23 |
| 1326559964 | Amber Wheatley Wood | Counselor | 724 N. 22nd Street, Saint Joseph, MO 64506 | 2017-10-23 |
| 1366952988 | Annette Burris | Audiologist | 2401 North Woodbine, St. Joseph, MO 64506 | 2017-10-10 |
| 1962927665 | Genuine Senior Care LLC | In Home Supportive Care | 3715 Beck Road, Suite 207b, St. Joseph, MO 64506 | 2017-08-03 |
| 1215396569 | Andrew M Fisher | Counselor | 2400 Frederick Blvd, Suite 407, Saint Joseph, MO 64506 | 2016-02-15 |
| 1699133678 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3320 North Belt Highway, St Joseph, MO 64506 | 2016-02-04 |
| 1598167587 | Quality Hearing and Audiology Center LLC | Audiologist | 2227 North Belt Highway, St. Joseph, MO 64506 | 2014-09-22 |
| Find all providers in zip 64506 | ||||
| Taxonomy Code | 224P00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Prosthetist |
| A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659987295 | Lake St. Louis Wigs and Cuts | Prosthetist | 950 Corporate Pkwy Ste 100, Wentzville, MO 63385-4851 | 2020-09-18 |
| 1093320962 | Nia L Taylor | Prosthetist | 411 Sw Ward Rd, Lees Summit, MO 64081-2448 | 2020-09-09 |
| 1053926964 | Deann Porter | Prosthetist | 8743 Mavis Place, St Louis, MO 63114 | 2020-09-09 |
| 1417458662 | Whitney Marie Witherspoon | Prosthetist | 3821 Vaile Ave, Florissant, MO 63034-2227 | 2018-02-23 |
| 1053657924 | Jazz Hair Institute | Prosthetist | 3950 Cook Ave, Saint Louis, MO 63113-3402 | 2012-12-21 |
| 1932445095 | Tamera Newberry | Prosthetist | 5248 Darkmoor Ln, Imperial, MO 63052-3036 | 2012-12-18 |
| 1972803773 | Frank T Coppolino Jr. | Prosthetist | 5425 Regency Woods Mnr, Imperial, MO 63052-1971 | 2010-10-26 |
| 1649507328 | Vikram Choudhary | Prosthetist | 6126 Washington Blvd, # 201, St. Louis, MO 63112 | 2009-11-17 |
| 1326197559 | Karen Christine Reiff | Prosthetist | 3230 S National Ave, Suite B, Springfield, MO 65807-7303 | 2007-01-09 |
| 1548348451 | Catherine S Sorrel I | Prosthetist | 41 State Road O Apt 1a, Macks Creek, MO 65786-9500 | 2006-11-01 |
| Find all providers with the same taxonomy | ||||
| City | SAINT JOSEPH |
| Zip Code | 64506 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.