Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gregory Petersen, PHD

Individual provider Clinical Psychologist · NPI 1275509804

Gregory Petersen, PHD is a Clinical Psychologist in Roanoke, Virginia. Qualified in 1999, 27 years ago. Practices with Northwestern Medical Faculty Foundation, a 4,394-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Virginia.

Years since qualifying
27
Licensed in
VA
In the registry since
2006
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone: (540) 981-7097
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 0810-002774 (VA)

Record details

NPI number1275509804
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedFebruary 24, 2006
Last updated in NPPESJuly 13, 2026
Mailing address411 Washington Ave Sw, Roanoke, VA 24016-4217

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Northwestern Medical Faculty Foundation — 4394 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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