DR. PEGGY JOANNE BURKE PH.D.
NPI 1124230644
Psychologist - Clinical Child & Adolescent in Grand Rapids, MI

Q: What is Peggy Burke's NPI number?

The NPI number for Peggy Burke is 1124230644. It was assigned to this individual provider in the NPPES registry on May 4, 2007.

Q: What is Peggy Burke's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Q: Is Peggy Burke enrolled in Medicare?

No. Peggy Burke has opted out of Medicare through August 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Peggy Burke was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 04, 2007Opted out of Medicare · through Aug 1, 2027

4467 CASCADE RD., SE, SUITE 4469, GRAND RAPIDS, MI 49546(616) 940-1659(616) 940-2853 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Peggy Joanne Burke Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PEGGY JOANNE BURKE PH.D. (NPI 1124230644) is an individual clinical child & adolescent provider in Grand Rapids, Michigan, licensed in Michigan (6301007618) and active in the NPI registry since May 2007. She has opted out of Medicare through August 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1124230644

Entity TypeIndividualFemale

Primary Taxonomy103TC2200X

Provider Legal NameDR. PEGGY JOANNE BURKECredential: PH.D.

Location Address4467 CASCADE RD., SE, SUITE 4469Grand Rapids, MI 49546-3632

Mailing Address4467 Cascade Rd., Se, Suite 4469Grand Rapids, MI 49546-3632 · (616) 940-1659 · Fax (616) 940-2853

Phone(616) 940-1659

Fax(616) 940-2853

Sole ProprietorYes

Enumeration DateMay 4, 2007

Last NPPES UpdateSeptember 11, 2025

✔ NPI 1124230644 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyPsychologist · Clinical Child & AdolescentBehavioral Health & Social Service Providers

Taxonomy Code103TC2200X

License✔ Licensed in MI · 6301007618

Definition

A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

Also ListedPsychologistTaxonomy 103T00000X · License 6301007618 (MI)

Also ListedPsychologist · Adult Development & AgingTaxonomy 103TA0700X · License 6301007618 (MI)

Also ListedPsychologist · Cognitive & BehavioralTaxonomy 103TB0200X · License 6301007618 (MI)

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 6301007618 (MI)

4467 CASCADE RD., SE, Grand Rapids, MI 49546

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Peggy Joanne Burke Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 1, 2009 through August 1, 2027.

Opt-Out Effective DateAugust 1, 2009

Opt-Out In Effect ThroughAugust 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Peggy Burke's NPI number?

The NPI number for Peggy Burke is 1124230644. It was assigned to this individual provider in the NPPES registry on May 4, 2007.

Where is Peggy Burke located?

Peggy Burke practices at 4467 Cascade Rd., SE Suite 4469, Grand Rapids, MI 49546. The listed phone number is (616) 940-1659.

What is Peggy Burke's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Is Peggy Burke enrolled in Medicare?

No. Peggy Burke has opted out of Medicare through August 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Peggy Burke was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.