Gail E Peterson

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10458 Issued in IN

Practice address

2526 Central Ave
Columbus, IN 47201-3121

Phone

(812) 376-7263

NPI assigned

Jul 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477526400000",
    "number": "1194739250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2526 CENTRAL AVE",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472013121",
            "telephone_number": "812-376-7263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2526 CENTRAL AVE",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472013121",
            "telephone_number": "812-376-7263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "GAIL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2016-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "10458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200397400",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adelfo Perez-Gonzalez, RBT
• Brittany Perez
• Kloei Perry
• Lauren Rae Perry, PHARMD
• Jawanna Persley
• Lillian S. Petro
• Marlene Ann Pettiford, M.A., CCC-SLP
• Dana Stuart Pfaff, MD
• Pharmacy Care Solutions, Inc
• Melissa Philippsen, M.A.,CCC-SLP

• General Practice Dentistry in Columbus, IN
• Providers in Columbus, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.