B D Peterson MD Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G66903 Issued in CA

Legal business name

B D PETERSON MD INC

Practice address

2390 Jackson Ave
Escalon, CA 95320-2078

Phone

(209) 838-6015

Fax

(209) 838-0750

NPI assigned

Aug 12, 2010

Last updated

Aug 12, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bob D Peterson, MD

Title

President

Phone

(209) 838-6015

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bobby Dean Peterson, M.D.

  • Family Medicine Physician
  • Escalon, CA
  • NPI 1841359171
  Medicare reassignment NPD

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

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281571200000",
    "number": "1114232204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2390 JACKSON AVE",
            "city": "ESCALON",
            "state": "CA",
            "postal_code": "953202078",
            "telephone_number": "209-838-6015",
            "fax_number": "209-838-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2390 JACKSON AVE",
            "city": "ESCALON",
            "state": "CA",
            "postal_code": "953202078",
            "telephone_number": "209-838-6015",
            "fax_number": "209-838-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B D PETERSON MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-12",
        "last_updated": "2010-08-12",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "BOB",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-838-6015",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G66903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine French Anderson
• Kelly Erin Arrighi, MA, PPS
• Cody Donald Avey, NP
• Mary Beth Baglione, R.D.,M.P.H.
• Brooke Ann Borden, MFT INTERN
• Jessica Calderon
• Daniel Cardenas, DDS
• Kacey Cheary

• Family Medicine Physician in Escalon, CA
• Providers in Escalon, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.