Michael J. Peterson M.D LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5354110-1205 Issued in UT

Legal business name

MICHAEL J. PETERSON M.D LLC

Practice address

5746 W 13400 S
Herriman, UT 84096-6907

Phone

(801) 253-4001

Fax

(801) 253-4003

NPI assigned

Jan 9, 2008

Last updated

Oct 7, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael J Peterson, M.D.NPI 1497794960

Title

Owner/Physician

Phone

(801) 253-4001

Specialties & licenses 1

Addresses

Other names 1

• HERRIMAN FAMILY MEDICINE Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael James Peterson, M.D.

  • Family Medicine Physician
  • Riverton, UT
  • NPI 1497794960
  Authorized official Same address or phone

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223337600000",
    "number": "1275718280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5746 W 13400 S",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840966907",
            "telephone_number": "801-253-4001",
            "fax_number": "801-253-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5746 W 13400 S",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840966907",
            "telephone_number": "801-253-4001",
            "fax_number": "801-253-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J. PETERSON M.D LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-10-07",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "801-253-4001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "5354110-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HERRIMAN FAMILY MEDICINE",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Saralyn Messegee
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• Sean A Miller, MPT
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• Kathleen Mitchell, FNP
• Monarch Family Counseling, PLLC

• Family Medicine Physician in Herriman, UT
• Providers in Herriman, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; 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.