Dennis R Peterson, M.D.P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

158238-1205 Issued in UT

Practice address

415 Medical Dr
Suite B200
Bountiful, UT 84010-4946

Phone

(801) 292-7254

Fax

(801) 295-5494

NPI assigned

Aug 30, 2006

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)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370476800000",
    "number": "1164532073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840110307",
            "telephone_number": "801-294-6907",
            "fax_number": "801-294-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MEDICAL DR",
            "address_2": "SUITE B200",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104946",
            "telephone_number": "801-292-7254",
            "fax_number": "801-295-5494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DENNIS",
        "middle_name": "R",
        "credential": "M.D.P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "158238-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krista Wilson Perry
• Ryan Perry, DPT
• Michelle Pesnell
• McKentri Petersen
• Bryce K Peterson, MD
• Kenzie Peterson
• Nathan Mark Peterson, LCSW
• Nicole Sheree Peterson, PA-C
• Paul Joseph Peterson, MSW
• Shantel Elizabeth Peterson, RN

• Family Medicine Physician in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; 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.