DR. JEFFERY J PETERSON (NPI# 1962491621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962491621 |
| Entity Type | Individual |
| Full Name | DR. JEFFERY J PETERSON |
| Credential | PH.D. |
| Practice Address |
11707 Club Dr Tampa Mhbs Clinic / Opc Tampa FL 33612-5521 |
| Practice Telephone | 8136317121 |
| Mailing Telephone | 8136317121 |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2007-08-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
1307 | AL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992041719 | Jeffery Allen Peterson | Nurse Anesthetist, Certified Registered | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2012-12-26 |
| 1639229255 | Jeffery Lee Peterson | Family Medicine | 701 W Broad Ave, Flandreau, SD 57028-1529 | 2007-01-12 |
| Street Address |
11707 CLUB DR TAMPA MHBS CLINIC / OPC |
| City | TAMPA |
| State | FL |
| Zip Code | 33612-5521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770922288 | Antonina Dijamco Chowdhari | Pediatrics | 11707 Club Dr, Tampa, FL 33612-5521 | 2013-06-18 |
| 1477801777 | University Pain Management Center, Pa | Non-Pharmacy Dispensing Site | 11707 Club Dr, Tampa, FL 33612-5521 | 2012-08-17 |
| 1346487394 | Jaime Lynne Milford | Psychologist | 11707 Club Dr, Jahva Outpatient Center (116b), Tampa, FL 33612-5521 | 2009-01-13 |
| 1144428426 | Robert Gene Zentarski | Counselor | 11707 Club Dr, Mental Health Outpatient Clinic, Tampa, FL 33612-5521 | 2007-07-06 |
| 1114958303 | David Warren Mackey | Social Worker | 11707 Club Dr, Tampa, FL 33612-5521 | 2006-07-05 |
| 1558315127 | James A. Haley Veterans Hospital | Substance Abuse Rehabilitation Facility | 11707 Club Dr, Tampa, FL 33612-5521 | 2006-05-19 |
| 1881663839 | Vidda Stutsman | Social Worker | 11707 Club Dr, Tampa, FL 33612-5521 | 2006-03-14 |
| 1154398386 | Alan Lewis Saunders | Psychologist | 11707 Club Dr, Mental Health Clinic, Tampa, FL 33612-5521 | 2006-03-07 |
| 1427023076 | Michelle G Levarge | Nurse Practitioner | 11707 Club Dr, Tampa, FL 33612-5521 | 2006-02-17 |
| 1730153396 | University Pain Management Center Inc | Pain Medicine | 11707 Club Dr, Tampa, FL 33612-5521 | 2006-02-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689286767 | Daniel Jimenez | Physical Therapist | 13000 Bruce B Downs Blvd, Tampa, Fl, Tampa, FL 33612 | 2020-08-19 |
| 1700426830 | Taz Stacy | Behavior Technician | 2701 University Square Drive, Tampa, FL 33612 | 2020-01-07 |
| 1841853215 | Eric Austen Keeler | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612 | 2019-04-20 |
| 1346700242 | Caitlyn Victoria Cartwright | Student in an Organized Health Care Education/Training Program | 12901 Bruce B. Downs Blvd., Mdc5, Tampa, FL 33612 | 2019-03-25 |
| 1720552953 | Marijo Bilitski | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd # Blvd5, Tampa, FL 33612 | 2019-01-22 |
| 1790259190 | Belkis Aleman | Nurse Practitioner | 205 E Busch Blvd, Tampa, FL 33612 | 2019-01-18 |
| 1811469133 | Stephanie Stegner | Physician Assistant | 12901 Bruce B Downs Blvd Mdc 5, Tampa, FL 33612 | 2018-12-27 |
| 1053889857 | Alysia Heather Siegel | Psychologist | 1300 Bruce B. Downs Boulevard, 116b, Tampa, FL 33612 | 2018-11-09 |
| 1295202489 | Daisy Baby Pulinilkumkalayil | Nurse Practitioner | 1426 W. Bush Blvd. Suite #105, Suite #105, Tampa, FL 33612 | 2018-10-26 |
| 1649745258 | Rachel Rene Shelton | Specialist/Technologist | Orthopedics and Sports Medicine, 13330 Usf Laurel Drive, Tampa, FL 33612 | 2018-10-10 |
| Find all providers in zip 33612 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518524859 | Elements of Intervention, LLC | Psychologist | 106 W Columbus Dr, Tampa, FL 33602-1440 | 2019-05-22 |
| 1396202404 | Leila Ibrahim Durr | Psychologist | 14055 Riveredge Dr Ste 250, Tampa, FL 33637-2141 | 2019-02-25 |
| 1437657806 | Tampa Bay Counseling Services, LLC | Psychologist | 5331 Primrose Lake Cir Ste 223, Tampa, FL 33647-3751 | 2018-01-31 |
| 1427596717 | Julius Denson II | Psychologist | 13409 Thomasville Cir Apt G, Tampa, FL 33617-9534 | 2017-02-07 |
| 1982958633 | Be-cos, Inc | Psychologist | 1603 North Florida Ave, Tampa, FL 33602-2615 | 2012-11-02 |
| 1326390329 | Jissenia Perez | Psychologist | 14008 Saulk Ct Apt 137, Tampa, FL 33613-3943 | 2012-10-15 |
| 1639424930 | Sheriece Sadberry | Psychologist | 6922 W Linebaugh Ave Ste 101c, Tampa, FL 33625 | 2012-07-23 |
| 1841526605 | Martha Wrenn Putney | Psychologist | 7958 Terrace Ridge Dr, Tampa, FL 33637-3000 | 2009-10-28 |
| 1376714188 | James John Messina | Psychologist | 6319 Chauncy St, Tampa, FL 33647-1106 | 2008-03-19 |
| 1215146246 | Susan Patricia Phillips | Psychologist | 17742 Nathans Dr, Tampa, FL 33647-2264 | 2007-05-22 |
| Find all providers in TAMPA | ||||
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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.