Charles Emerson Peterman III, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL849 Issued in FL

Practice address

4600 4TH St N
St Petersburg, FL 33703-3802

Phone

(727) 369-5039

NPI assigned

May 11, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234828800000",
    "number": "1073728275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 21ST AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337135035",
            "telephone_number": "727-452-4283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 4TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337033802",
            "telephone_number": "727-369-5039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERMAN",
        "first_name": "CHARLES",
        "middle_name": "EMERSON",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2009-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Pfund Persons, PH.D.
• Laura A Pescatore, M.S.,CCC-SLP
• Laura L Pescod, P.T., M.P.T.
• Robin E. Pete, LCSW
• Peter L Sarkos MD PL
• Brittany Peters, DSW, LCSW
• Gina Peters, RN
• Kimberly Sue Peters, LMHC
• Robert L Peters, DPT
• Stephanie Peters

• Athletic Trainer in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.