Gerald W Peterson Jr LTD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

304 Issued in NV

Legal business name

GERALD W PETERSON JR LTD

Practice address

119 St. Patrick LN.
Tonopah, NV 89049

Phone

(775) 482-9898

Fax

(775) 482-9900

NPI assigned

Feb 19, 2007

Last updated

Jun 21, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gerald Wilbur Peterson Jr., D.O.

Title

President

Phone

(775) 482-9898

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eljena Marie Peterson, APRN FNP

  • Family Nurse Practitioner
  • Tonopah, NV
  • NPI 1306341656
  NPD (past)

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340236800000",
    "number": "1033253174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1628",
            "city": "TONOPAH",
            "state": "NV",
            "postal_code": "890491628",
            "telephone_number": "775-482-9898",
            "fax_number": "775-482-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 ST. PATRICK LN.",
            "city": "TONOPAH",
            "state": "NV",
            "postal_code": "89049",
            "telephone_number": "775-482-9898",
            "fax_number": "775-482-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERALD W PETERSON JR LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2012-06-21",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "WILBUR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "775-482-9898",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Susan Horne
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• Family Medicine Physician in Tonopah, NV
• Providers in Tonopah, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; 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.