Geoff Peterson

Primary specialty

DentistTaxonomy code 122300000X

License

2013025331 Issued in MO

Practice address

3751 SW Hollywood Dr
Lees Summit, MO 64082-7830

Phone

(816) 623-3563

NPI assigned

Jul 18, 2013

Last updated

Jul 18, 2013By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MO

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

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JGBBCA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• HCC Network

  dba Live Well Community Health Center-Waverly

  • Federally Qualified Health Center (FQHC)
  • Waverly, MO
  • NPI 1174960769
  NPD (past)
• HCC Network

  dba Live Well Community Health Center Buckner

  • Federally Qualified Health Center (FQHC)
  • Buckner, MO
  • NPI 1174992374
  NPD (past)
• HCC Network

  • Federally Qualified Health Center (FQHC)
  • Carrollton, MO
  • NPI 1255114559
  NPD (past)
• HCC Network

  dba Live Well Community Health Center Independence

  • Federally Qualified Health Center (FQHC)
  • Independence, MO
  • NPI 1760150817
  NPD (past)
• HCC Network

  dba Live Well Community Health Center-Concordia

  • Federally Qualified Health Center (FQHC)
  • Concordia, MO
  • NPI 1992142582
  NPD (past)

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

{
    "created_epoch": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1285076364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3751 SW HOLLYWOOD DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640827830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 SW HOLLYWOOD DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640827830",
            "telephone_number": "816-623-3563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "GEOFF",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-18",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2013025331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathy Marie Persell, RN
• Caly Person, PHARM. D.
• Jessica Peters
• Anne Peterson, OTR
• Erin Elizabeth Peterson, RN, BSN, IBCLC
• Patti K Peterson, LPC
• Tamara Lee Peterson, D.O.
• Dawn Lynette Petty, N.P.
• Phillip Montoya, DDS LLC
• Amy D Phillips, C.P.N.P.

• Dentist in Lee's Summit, MO
• Providers in Lee's Summit, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; 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.