Individual provider Active NPI

William S. Peterson, M.D.

  • Emergency Medicine Physician
  • Dallas, TX
National Provider Identifier
1154301588
Registry record updated Feb 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
N1065 Issued in TX
Practice address
5201 Harry Hines Blvd
Dallas, TX 75235-7708
Phone
(214) 786-2719
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X N1065 TX Primary

Addresses

Primary practice location

5201 Harry Hines Blvd
Dallas, TX 75235-7708

Mailing address

2613 Halsey Dr
Flower Mound, TX 75028-1474
Phone (214) 513-7929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090324000376 TX Practitioner - Emergency Medicine 4284791922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Ohio, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Medicine Resources, LLPGroup PAC ID 5890688212, 255 clinicians

Practice addresses (Care Compare)

6200 W Parker Rd
Plano, TX 75093-8185
Phone (972) 981-8000

Hospital & facility affiliations

  • Texas Health Presbyterian Hospital Plano Hospital, Plano, TX, CCN 450771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
N1065TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Medicine Resources, LLP Emergency Medicine CurrentSince Apr 15, 2013 Accepting new patients

Locations

1105 Central Expy N
Allen, TX 75013
Phone (972) 747-4313

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

Organizations & group practices 1

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424304000000",
    "number": "1154301588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2613 HALSEY DR",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750281474",
            "telephone_number": "214-513-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357708",
            "telephone_number": "214-786-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "WILLIAM",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2015-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "N1065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.