Gary C Peterson, NP – Family Nurse Practitioner

Key facts

NPI: 1184759359
Entity type: Individual (NPI type 1)
Primary specialty: Family Nurse Practitioner 363LF0000X
License: 80231 (CO)
Practice address: 482 Adams Ave
Akron, CO 80720-1149
Phone: (970) 345-2262
Fax: (970) 345-2265
NPI assigned: Feb 21, 2007
Sex: Male
Sole proprietor: No

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.

Yuma District Hospital Critical Access Hospital · Yuma, CO · NPI 1629074182

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
HHS exclusion list flag: The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials: Nurse Practitioner

Practice roles

Organization	Specialty	Status	New patients
Yuma District Hospital		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Nurse Practitioner	363LF0000X	80231	CO	Yes

Addresses

Primary practice location

482 Adams Ave
Akron, CO 80720-1149

Mailing address

482 Adams Ave
Akron, CO 80720-1149
Phone (970) 345-2262

Other identifiers

Identifier	Type	State	Issuer
05638457	Medicaid	CO
80231	Other	CO	LICENSE

Other providers in Akron, CO

All providers in Akron, CO · Family Nurse Practitioner in Colorado

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.