DR. PHILLIP O PEGG JR. (NPI# 1508802893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508802893 |
| Entity Type | Individual |
| Full Name | DR. PHILLIP O PEGG JR. |
| Other Name | DR. PHILLIP O PEGG JR. |
| Credential | PH.D |
| Practice Address |
2790 Clay Edwards Dr Ste 1250 C/o Hellman & Rosen Endocrine North Kansas City MO 64116-3260 |
| Practice Telephone | 8164213700 |
| Practice Fax Number | 8164211654 |
| Mailing Telephone | 8164213700 |
| Mailing Fax Number | 8164211654 |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2016-06-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
1390 | KY | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PYT0122 | MO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | RAILROAD MEDICARE | P01644526 | 01 |
| Street Address |
2790 CLAY EDWARDS DR STE 1250 C/O HELLMAN & ROSEN ENDOCRINE |
| City | NORTH KANSAS CITY |
| State | MO |
| Zip Code | 64116-3260 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437193133 | Debra E Mcconville | Nurse Practitioner | 2790 Clay Edwards Dr Ste 1250, C/o Hellman & Rosen Endocrine, North Kansas City, MO 64116-3260 | 2006-06-15 |
| 1306478193 | Mayra Salazar | Nurse Practitioner | 2790 Clay Edwards Dr Ste 1250, North Kansas City, MO 64116-3260 | 2020-02-10 |
| 1285295188 | Dylan Todd Smith-sutton | Physician Assistant | 2790 Clay Edwards Dr Ste 1250, North Kansas City, MO 64116-3260 | 2019-06-22 |
| 1659731271 | Kelly Schrock | Dietitian, Registered | 2790 Clay Edwards Dr Ste 1250, C/o Hellman & Rosen Endocrine, North Kansas City, MO 64116-3260 | 2016-02-24 |
| 1275902397 | Kevan Stout | Physician Assistant | 2790 Clay Edwards Dr Ste 1250, North Kansas City, MO 64116-3260 | 2015-09-18 |
| 1629464631 | Duyen Thi My Nguyen | Nurse Practitioner | 2790 Clay Edwards Dr Ste 1250, North Kansas City, MO 64116-3260 | 2015-04-07 |
| 1043612609 | Samantha Kisicki | Physician Assistant | 2790 Clay Edwards Dr Ste 1250, North Kansas City, MO 64116-3260 | 2014-09-25 |
| 1396085395 | Misty Nicole Stambach | Physician Assistant | 2790 Clay Edwards Dr Ste 1250, North Kansas City, MO 64116-3260 | 2013-02-27 |
| 1700150968 | Michelle Tremain | Nurse Practitioner | 2790 Clay Edwards Dr Ste 1250, North Kansas City, MO 64116-3260 | 2012-03-05 |
| 1245523141 | Avin Pothuloori | Internal Medicine | 2790 Clay Edwards Dr Ste 1250, C/o Hellman & Rosen Endocrine, North Kansas City, MO 64116-3260 | 2011-05-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326503830 | Ladeja Holland | Student in an Organized Health Care Education/Training Program | 4421 N Oak Trfy, Kansas City, MO 64116 | 2019-02-08 |
| 1982179388 | Casady's Counseling | Counselor | 1201 Nw Briarcliff Pkwy Ste 200 Office233, Kansas City, MO 64116 | 2018-10-11 |
| 1427543818 | Amanda E Foster | Physical Therapist | 3810 N Mulberry Drive 202, Kansas City, MO 64116 | 2018-06-27 |
| 1992290555 | Lucas J Mathes | Physician Assistant | 2790 Clay Edwards Drive, Suite 650, North Kansas City, MO 64116 | 2018-06-26 |
| 1952828816 | Danielle Marie Rush | Physical Therapist | 1501 Nw 38th St., Apt. 305, Kansas City, MO 64116 | 2017-08-23 |
| 1992229629 | Ankita Bhakta | Physical Therapy Assistant | 4407 N Mulberry Dr, Kansas City, MO 64116 | 2017-08-03 |
| 1720430945 | Deon Hicks | Physical Therapist | 851 Nw 45th Street, Suite 209, Kansas City, MO 64116 | 2016-07-12 |
| 1851712228 | Cindy Eldridge | Counselor | 1201 Nw Briarcliff Pkwy Ste 200, Kansas City, MO 64116 | 2014-01-02 |
| 1841629904 | Jamie Lyn Jackson | Specialist/Technologist | 2790 Clay Edwards Dr. Ste #650, North Kansas City, MO 64116 | 2013-11-08 |
| 1487099388 | Lisa M Grasing | Family Medicine | 4150 N. Mulberry Dr, Suite 160, Kansas City, MO 64116 | 2013-05-06 |
| Find all providers in zip 64116 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538191234 | Rebecca Linnea St John | Psychologist | 2029 Buchanan, North Kansas City, MO 64116 | 2006-07-06 |
| 1972526713 | Robert Urie | Psychologist | 2029 Buchanan St, North Kansas City, MO 64116-3405 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911370 | Sarah Marie Whitman | Psychologist | 500 Huber Park Ct Ste 205, Weldon Spring, MO 63304-8683 | 2020-10-27 |
| 1215541040 | Charles A Burgess | Psychologist | 119 Parker Hall, Columbia, MO 65211-2340 | 2020-08-31 |
| 1184242810 | Kristen Casey | Psychologist | 4050 Pennsylvania Ave Ste 115, Pmb 2746, Kansas City, MO 64111 | 2020-07-09 |
| 1174147649 | Melissa Turkel | Psychologist | 915 N Grand Blvd # 116-jc, Saint Louis, MO 63106-1621 | 2020-06-01 |
| 1851910335 | Columbia Psychology Healing Center LLC | Psychologist | 1900 N Providence Rd Ste 327, Columbia, MO 65202-3710 | 2020-04-14 |
| 1629600085 | Dr Richard Heise LLC | Psychologist | 10621 Midland Manor Ct, Saint Louis, MO 63114-1202 | 2020-02-04 |
| 1598302226 | Taylor Montgomery | Psychologist | 12837 Flushing Meadows Dr Ste 220, Saint Louis, MO 63131-1824 | 2019-12-02 |
| 1528523420 | Daniel Franco | Psychologist | 4501 Kentsfield Ln, Columbia, MO 65201-3587 | 2019-02-05 |
| 1265917884 | Gillian Sloane Mayersohn | Psychologist | 1 Childrens Pl Ste 3n14, Saint Louis, MO 63110-1002 | 2018-09-28 |
| 1215421581 | Samuel L Kramer | Psychologist | 16216 Baxter Rd Ste 205, Chesterfield, MO 63017-4778 | 2018-06-19 |
| Find all providers with the same taxonomy | ||||
| City | NORTH KANSAS CITY |
| Zip Code | 64116 |
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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.