Active NPI
Bethanie Gardiner Peterson, PHARM D
- Pharmacist
- Taylorsville, UT
National Provider Identifier
1235602343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 3619011701
- Practice address
- 5469 S Redwood Rd
Taylorsville, UT 84123-5318 - Phone
- (801) 264-9797
- NPI assigned
- Jan 10, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 3619011701 | UT | Primary |
Addresses
Primary practice location
5469 S Redwood Rd
Taylorsville, UT 84123-5318
Mailing address
15228 S Steep Mountain Dr
Draper, UT 84020-5109
Phone (801) 633-4966
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3619011701 | UT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547078400000",
"number": "1235602343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15228 S STEEP MOUNTAIN DR",
"city": "DRAPER",
"state": "UT",
"postal_code": "840205109",
"telephone_number": "801-633-4966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5469 S REDWOOD RD",
"city": "TAYLORSVILLE",
"state": "UT",
"postal_code": "841235318",
"telephone_number": "801-264-9797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "BETHANIE",
"middle_name": "GARDINER",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-10",
"last_updated": "2019-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "3619011701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taylorsville, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.