Donald Leon Peterson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1290T Issued in OR

Practice address

813 SW Highland Ave
Redmond, OR 97756-3123

Phone

(541) 548-7170

NPI assigned

Aug 11, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• La Grande Family Eye Care

  • Eyewear Supplier
  • La Grande, OR
  • NPI 1376773960

  Optometrist

  NPD (past)
• Family Vision Care of Yakima PC

  • Optometrist
  • Yakima, WA
  • NPI 1558463208
  NPD (past)
• Pacific Cataract and Laser Institute, Inc., P.C.

  • Ambulatory Surgical Clinic/Center
  • Chehalis, WA
  • NPI 1114978848
  NPD (past)
• Pacific Cataract and Laser Institute, Inc., P.C.

  • Ophthalmologic Surgery Clinic/Center
  • Auburn, WA
  • NPI 1528814647
  NPD (past)

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1215939137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 SW HIGHLAND AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977563123",
            "telephone_number": "541-548-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 SW HIGHLAND AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977563123",
            "telephone_number": "541-548-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DONALD",
        "middle_name": "LEON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1290T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "236067",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "A002",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clare Elena Perez, CRM
• Lawrence Joseph Perez
• Mary Lauren Periman, CRM
• Jessica Perkins, PT, DPT
• Kimberly Ann Perlot, EPDH, RDH
• Kelsey Rose Peterson, PA-C
• Leif Eric Petterson Jr., NP
• Nichole Petterson, FNP
• Hailey Pettijohn
• Kelly R Pettit, MD

• Optometrist in Redmond, OR
• Providers in Redmond, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; 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.