Individual provider Active NPI

Peter E Jamieson, PA

  • Physician Assistant
  • Durango, CO
National Provider Identifier
1023073475
Registry record updated Aug 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
816 Issued in CO
Practice address
1 Mercado St
Suite 202
Durango, CO 81301-7306
Phone
(970) 247-5362
Fax
(970) 259-6045
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 816 CO Primary

Addresses

Primary practice location

1 Mercado St
Suite 202
Durango, CO 81301-7306

Mailing address

1 Mercado St
Suite 202
Durango, CO 81301-7306
Phone (970) 247-5362

Other identifiers 1

IdentifierTypeStateIssuer
CO0304953OtherCOMEDICARE PROVIDER NUMBER PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
816COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Field T. Blevins MD PC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22261/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249516800000",
    "number": "1023073475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MERCADO ST",
            "address_2": "SUITE 202",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017306",
            "telephone_number": "970-247-5362",
            "fax_number": "970-259-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MERCADO ST",
            "address_2": "SUITE 202",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017306",
            "telephone_number": "970-247-5362",
            "fax_number": "970-259-6045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMIESON",
        "first_name": "PETER",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2009-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER PTAN",
            "identifier": "CO0304953",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.