Robert L. Peterson, M.D., S.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ROBERT L. PETERSON, M.D., S.C.

Practice address

900 Riverside Dr
Suite III
Waupaca, WI 54981-1983

Phone

(715) 258-8898

Fax

(715) 258-6980

NPI assigned

Apr 9, 2007

Organization subpart

No

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

Authorized official

Name

Robert Lester Peterson, M.D.NPI 1720144876

Title

President

Phone

(715) 258-8898

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Lester Peterson, M.D.

  • Family Medicine Physician
  • Waupaca, WI
  • NPI 1720144876
  NPD (past) Authorized official

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063535706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RIVERSIDE DR",
            "address_2": "SUITE III",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549811983",
            "telephone_number": "715-258-8898",
            "fax_number": "715-258-6980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 RIVERSIDE DR",
            "address_2": "SUITE III",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549811983",
            "telephone_number": "715-258-8898",
            "fax_number": "715-258-6980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT L. PETERSON, M.D., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LESTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-258-8898",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Michael Reybrock, MPT
• Jean L Rice, DC
• Sandra S Rice, PTA
• Richard S Veiga MD SC
• Riverhill Dental Assoc DDS SC
• James Ross Robinson, DDS
• Roots Wholistic Health
• Dennise Ross, PHARMD, RPH
• Hannah Rowe, RN
• Lauren Michelle Rowe

• Family Medicine Physician in Waupaca, WI
• Providers in Waupaca, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.