Lee M Peterson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

1766331205 Issued in UT

Practice address

3550 N University Ave
Suite 250
Provo, UT 84604

Phone

(801) 374-9625

Fax

(801) 374-9690

NPI assigned

Jun 7, 2006

Last updated

Jul 9, 2026By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Utah Weight Loss, LLC

  • Dietary Manager
  • Provo, UT
  • NPI 1720447766
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1316987613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 N UNIVERSITY AVE",
            "address_2": "SUITE 250",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84604",
            "telephone_number": "801-374-9625",
            "fax_number": "801-374-9690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 N UNIVERSITY AVE",
            "address_2": "SUITE 250",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84604",
            "telephone_number": "801-374-9625",
            "fax_number": "801-374-9690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "LEE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "UT",
            "license": "1766331205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870516264009",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David L Peterson, P.A
• Diane J. Peterson, LMFT
• Jennifer Griffith Peterson, LMFT
• Joshua Phillip Peterson
• Kirstin Chantell Peterson
• Maylan Peterson
• Michael C Peterson, M.D.
• Misty Peterson
• Natalie Peterson, PA-C
• Nathan Robert Peterson, M.D.

• Surgery Physician in Provo, UT
• Providers in Provo, UT by specialty
• Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; 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.