Carl Peters, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2009012802 Issued in MO

Practice address

12348 Old Tesson Rd
Suite 180
Saint Louis, MO 63128-2251

Phone

(314) 467-2014

Fax

(314) 467-2170

NPI assigned

Sep 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: carl.peters@393409484357636.direct.elationemr.com

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.

• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)
• Windber Hospital, Inc.

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410220800000",
    "number": "1053403915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12348 OLD TESSON RD",
            "address_2": "SUITE 180",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282251",
            "telephone_number": "314-467-2014",
            "fax_number": "314-467-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12348 OLD TESSON RD",
            "address_2": "SUITE 180",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282251",
            "telephone_number": "314-467-2014",
            "fax_number": "314-467-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "CARL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2014-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036099983",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2009012802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205521800",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036099983",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Peterein, AU.D.
• Judy L Peterein, AUD
• Leia Alexandra Peterman-Prather, CGC
• Katherine Peterman
• Bradley Christopher Peters
• Cynthia Peters
• Daniel Joseph Peters, PLPC
• Emily Grace Peters, NP
• Erin Ashley Peters, PT
• Jerome Peters, D.O.

• Family Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; 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.