Individual provider Active NPI

Dana Corrinne Peterman, M.D.

  • Pediatrics Physician
  • Dallas, TX
National Provider Identifier
1083645741
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
L3430 Issued in TX
Practice address
8350 N Central Expy
Suite M1025
Dallas, TX 75206-1600
Phone
(214) 368-6341
Fax
(214) 368-5803
NPI assigned
Jul 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 L3430 TX Primary

Addresses

Primary practice location

8350 N Central Expy
Suite M1025
Dallas, TX 75206-1600

Mailing address

8350 N Central Expy
Suite M1025
Dallas, TX 75206-1600
Phone (214) 368-6341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L3430TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William H. Moore, M.D., P.a. Past Accepting new patients
Christopher S. Abel, M.D., P.a. PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083645741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8350 N CENTRAL EXPY",
            "address_2": "SUITE M1025",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752061600",
            "telephone_number": "214-368-6341",
            "fax_number": "214-368-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8350 N CENTRAL EXPY",
            "address_2": "SUITE M1025",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752061600",
            "telephone_number": "214-368-6341",
            "fax_number": "214-368-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERMAN",
        "first_name": "DANA",
        "middle_name": "CORRINNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L3430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.