Paula C. Peterson, OD, PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0477 Issued in AZ

Legal business name

PAULA C. PETERSON, OD, PC

Practice address

440 N Alvernon Way
Tucson, AZ 85711-1958

Phone

(520) 881-2188

Fax

(520) 327-0368

NPI assigned

May 14, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Stacia A Decker

Title

VP of Retail

Phone

(520) 327-6215

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1273795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273795200000",
    "number": "1083932016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 N ALVERNON WAY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111958",
            "telephone_number": "520-881-2188",
            "fax_number": "520-327-0368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 N ALVERNON WAY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111958",
            "telephone_number": "520-881-2188",
            "fax_number": "520-327-0368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAULA C. PETERSON, OD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-14",
        "last_updated": "2010-05-14",
        "status": "A",
        "authorized_official_last_name": "DECKER",
        "authorized_official_first_name": "STACIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP OF RETAIL",
        "authorized_official_telephone_number": "520-327-6215",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "0477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034421",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derek Paul, M.D.
• Miki Paul, PH.D.
• Simon P Paul, MD
• Srijit Paul, MD
• Stephen R Paul, MD
• Paula Weisbrodt-Kelly, Ms, Otr.L
• Norma J Paulic, LCSW
• Irma Irene Paulley, D.D.S.
• Karen A. Paulsen-Balch, PH.D.
• Claire Pavlak, PT

• Optometrist in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2010; 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.