MR. PETER SHANE KIDNOCKER (NPI# 1376141564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376141564 |
| Entity Type | Individual |
| Full Name | MR. PETER SHANE KIDNOCKER |
| Credential | CDCA |
| Practice Address |
519 Court St Portsmouth OH 45662-3933 |
| Practice Telephone | 7408764370 |
| Practice Fax Number | 7405291313 |
| Mailing Telephone | 7408764370 |
| Mailing Fax Number | 7405291313 |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2020-10-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
519 COURT ST |
| City | PORTSMOUTH |
| State | OH |
| Zip Code | 45662-3933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023633625 | Jesse Mccown | Counselor | 519 Court St, Portsmouth, OH 45662-3933 | 2020-06-10 |
| 1447802012 | David Hufferd | Counselor | 519 Court St, Portsmouth, OH 45662 | 2019-07-12 |
| 1023676046 | Matthew Peoples | Counselor | 519 Court St, Portsmouth, OH 45662-3933 | 2019-06-04 |
| 1639737802 | Joseph Young | Counselor | 519 Court St, Portsmouth, OH 45662-3933 | 2019-06-03 |
| 1033695051 | Shawnee Counseling Center LLC | Substance Abuse Rehabilitation Facility | 519 Court St, Portsmouth, OH 45662-3933 | 2018-07-12 |
| 1437658036 | Amanda M Staggs | Counselor | 519 Court St, Portsmouth, OH 45662 | 2018-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528613346 | Stacia N Boyer | Nurse Practitioner | 1611 27th Street, Fulton Bldg Suite 101, Portsmouth, OH 45662 | 2019-08-08 |
| 1487210167 | Rose Speier | Registered Nurse | 920 Gallia Street, Portsmouth, OH 45662 | 2019-05-17 |
| 1083123491 | Megan Rhea | Case Manager/Care Coordinator | 901 Wahington St, Portsmouth, OH 45662 | 2017-09-28 |
| 1376061903 | Alanna Lee Reisinger | Physical Therapist | 522 Glenwood Ave., New Boston, OH 45662 | 2017-09-04 |
| 1871010967 | Nicole Lynne Johnson | Counselor | 800 Gallia Street Suite 600, Portsmouth, OH 45662 | 2017-08-29 |
| 1629595822 | William Zachary Nance | Counselor | 800 Gallia Street, Suite 600, Portsmouth, OH 45662 | 2017-08-28 |
| 1962929703 | Melissa Rodbell | Speech-Language Pathologist | 514 Union St., Portsmouth, OH 45662 | 2017-08-23 |
| 1346604626 | Todd Davis | Counselor | 2954 Walnut St., Portsmouth, OH 45662 | 2016-04-12 |
| 1083078406 | Gordon Sanders | Counselor | 2954 Walnut Street, Portsmouth, OH 45662 | 2016-04-12 |
| 1033573910 | Michael L Purdy | Nurse Practitioner | 1735 27th Street Waller Bldg Suite 302, Portsmouth, OH 45662 | 2016-04-07 |
| Find all providers in zip 45662 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346858305 | Gwendolyn Daniels Slade | Counselor | 9 Canoe Ct, Portsmouth, VA 23703-5380 | 2020-07-16 |
| 1801410550 | Tequila Marie Estep | Counselor | 1870 Swauger Valley Rd, Portsmouth, OH 45662-9097 | 2020-05-28 |
| 1477174126 | Hollie Sue Maund | Counselor | 1619 Chillicothe St, Portsmouth, OH 45662-3477 | 2020-05-05 |
| 1730748260 | Mary Yost | Counselor | 212 Islington St, Portsmouth, NH 03801-4204 | 2019-06-09 |
| 1871150961 | Southern Hope Recovery Center | Counselor | 4342 Gallia St Ste A, Portsmouth, OH 45662-5563 | 2019-05-23 |
| 1851878540 | Laura K Lennex | Counselor | 5611 Gallia St, Portsmouth, OH 45662-5520 | 2018-07-25 |
| 1851880827 | Latiesha Davis Wiggins | Counselor | 355 Crawford St Ste 502, Portsmouth, VA 23704-2822 | 2018-05-06 |
| 1437667045 | Angela Dyke | Counselor | 1907 11th St, Portsmouth, OH 45662-4531 | 2018-01-17 |
| 1104338870 | Aryn Brown | Counselor | 1311 2nd St, Portsmouth, OH 45662-4602 | 2017-11-02 |
| 1871010967 | Nicole Lynne Johnson | Counselor | 800 Gallia Street Suite 600, Portsmouth, OH 45662 | 2017-08-29 |
| Find all providers in PORTSMOUTH | ||||
| City | PORTSMOUTH |
| Zip Code | 45662 |
Please comment or provide details below to improve the information on MR. PETER SHANE KIDNOCKER.
| 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.