Individual provider Active NPI

Emily K Peterson, DO

  • Pediatrics Physician
  • Henderson, NV
National Provider Identifier
1033353032
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DO1689 Issued in NV
Practice address
98 E Lake Mead Pkwy Ste 102
Henderson, NV 89015-6443
Phone
(702) 868-0327
Fax
(702) 868-0290
NPI assigned
Apr 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DO1689 NV Primary

Addresses

Primary practice location

98 E Lake Mead Pkwy Ste 102
Henderson, NV 89015-6443

Mailing address

3325 Research Way
Carson City, NV 89706-7913
Phone (702) 222-9902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140916002339 NV Practitioner - Pediatric Medicine 6800015348 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Incredicare Primary Care Inc Pediatrics CurrentSince Jan 12, 2025 Accepting new patients
Incredicare Pediatrics Pediatrics PastSince Jul 2, 2023 Accepting new patients

Locations

5510 S Fort Apache Rd
#465
Las Vegas, NV 89148
Phone (725) 867-8144

Organizations & group practices 3

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": "1240358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1033353032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 RESEARCH WAY",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897067913",
            "telephone_number": "702-222-9902",
            "fax_number": "702-323-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 E LAKE MEAD PKWY STE 102",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890156443",
            "telephone_number": "702-868-0327",
            "fax_number": "702-868-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "EMILY",
        "middle_name": "K",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-22",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "DO1689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.