Ryan Peterson O.D., Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

RYAN PETERSON O.D., INC.

Practice address

6370 W Flamingo Rd Ste 8
Las Vegas, NV 89103-2275

Phone

(702) 331-0777

Fax

(877) 832-5115

NPI assigned

Jul 12, 2017

Organization subpart

Yes

Parent organization

RYAN PETERSON O.D.,INC.As reported in NPPES

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

Authorized official

Name

Ryan Peterson, ODNPI 1902864614

Title

Owner

Phone

(702) 299-6200

Specialties & licenses 1

Addresses

Tax ID family

Ryan Peterson OD Inc2 organizations share this tax ID, including this one

Part of

Ryan Peterson OD Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ryan Peterson O.D., Inc.

  • Optometrist
  • Las Vegas, NV
  • NPI 1962420455
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan Kent Peterson, O.D.

  • Optometrist
  • Henderson, NV
  • NPI 1902864614
  NPD (past) Authorized official

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499817600000",
    "number": "1194247015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 E SUNSET RD STE 4",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890142200",
            "telephone_number": "702-299-6200",
            "fax_number": "702-331-4533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6370 W FLAMINGO RD STE 8",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891032275",
            "telephone_number": "702-331-0777",
            "fax_number": "877-832-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN PETERSON O.D., INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RYAN PETERSON O.D.,INC.",
        "enumeration_date": "2017-07-12",
        "last_updated": "2017-07-12",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-299-6200",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Las Vegas, NV
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2017; 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.