Christina E Peterson, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

MD13675 Issued in OR

Practice address

15259 SE 82ND Dr
201B
Clackamas, OR 97015-6609

Phone

(503) 656-9844

Fax

(503) 656-3120

NPI assigned

Dec 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 22, 2016 through Mar 22, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251849600000",
    "number": "1245394022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15259 SE 82ND DR",
            "address_2": "201B",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156609",
            "telephone_number": "503-656-9844",
            "fax_number": "503-656-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15259 SE 82ND DR",
            "address_2": "201B",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156609",
            "telephone_number": "503-656-9844",
            "fax_number": "503-656-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CHRISTINA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2009-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "MD13675",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AK",
            "license": "2839",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Persmark, MD
• Andrea Christine Pertoso, PA-C
• Jon Peters, MD
• Kimberly Petersen
• Tamaryn Petersen
• James Peterson, CRNA
• Jessica Ann Peterson, L.AC.
• Sean Luke Peterson, M.D.
• Nicholas Petrochko Jr., M.D.
• Vennessa Petrov

• Neurology Physician in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Neurology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2009; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.