Cameron Glade Peterson, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

357812-1205 Issued in UT

Practice address

1300 N 500 E
Logan, UT 84341-2408

Phone

(435) 716-2800

NPI assigned

Dec 5, 2007

Last updated

Feb 2, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in UT, OR2 enrollments

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 2

Specialty

Physical Medicine and Rehabilitation

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wasatch Post-Acute ServicesGroup PAC ID 1052786993, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeastern Nevada Regional Hospital Hospital, Elko, NV, CCN 290008
• Northern Utah Rehabilitation Hospital Inpatient rehabilitation facility, South Ogden, UT, CCN 463027
• Utah Valley Specialty Hospital Inpatient rehabilitation facility, Provo, UT, CCN 46TA05

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Merit-based Incentive Payment System (MIPS)

Final score

61.24 of 100Reported as group

Quality

58.16

Promoting interoperability

0

Improvement activities

40

Cost

62.65

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Wasatch Post-Acute Services

  • Physical Medicine & Rehabilitation Physician
  • Ogden, UT
  • NPI 1144922477
  Medicare reassignment Care Compare group NPD
• Claris Health PLLC

  • General Practice Physician
  • Irving, TX
  • NPI 1356797070

  UT

  Medicare reassignment
• Bridge Medical Consulting

  • Family Medicine Physician
  • West Valley, UT
  • NPI 1194076398

  Physical Medicine & Rehabilitation

  NPD (past)

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

• Northern Utah Rehabilitation Hospital LLC

  • Rehabilitation Hospital
  • South Ogden, UT
  • NPI 1053732024

  Inpatient rehabilitation facility

  Care Compare affiliation
• Utah Valley Specialty Hospital Inc

  • Long Term Care Hospital
  • Provo, UT
  • NPI 1760412530

  Inpatient rehabilitation facility

  Care Compare affiliation
• Utah Valley Specialty Hospital Inc

  dba Central Utah Rehabilitation

  • Rehabilitation Hospital
  • Provo, UT
  • NPI 1790551794

  Inpatient rehabilitation facility

  Care Compare affiliation
• PHC-Elko Inc

  dba Northeastern Nevada Regional Hospital

  • Rural Acute Care Hospital
  • Elko, NV
  • NPI 1770674350
  Care Compare affiliation

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517529600000",
    "number": "1164604765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 239",
            "city": "RUPERT",
            "state": "ID",
            "postal_code": "833500239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 500 E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412408",
            "telephone_number": "435-716-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CAMERON",
        "middle_name": "GLADE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-05",
        "last_updated": "2018-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "UT",
            "license": "357812-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chase B Petersen, M.D.
• Kent H Petersen, PHARM.D.
• Tyson Don Petersen, D.D.S.
• Ashley Elizabeth Peterson, FNP-BC
• Brent E. Peterson, D.C.
• David Erik Peterson, MD
• Frank E Peterson, M.D.
• Justin Peterson, MD
• Macy Peterson
• Taylor V Pettit, DDS

• Physical Medicine & Rehabilitation Physician in Logan, UT
• Providers in Logan, UT by specialty
• Physical Medicine & Rehabilitation Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.