Organization Active NPI

David a Petersen MD PA

  • Specialist
  • Clearwater, FL
National Provider Identifier
1336362888
Registry record updated Jul 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME54499 Issued in FL
Legal business name
DAVID A PETERSEN MD PA
Practice address
1000 Lakeview Rd 2
Clearwater, FL 33756-3475
Phone
(727) 724-3985
Fax
(727) 726-7553
NPI assigned
Apr 11, 2007
Last updated
Jul 8, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2013

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

Authorized official

Name
David A Petersen, MDNPI 1750363149
Title
Owner
Phone
(727) 724-3985

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME54499 FL Primary

Addresses

Primary practice location

1000 Lakeview Rd 2
Clearwater, FL 33756-3475

Mailing address

1000 Lakeview Rd 2
Clearwater, FL 33756-3475
Phone (727) 724-3985

National Provider Directory

National Provider Directory

Locations

1000 Lakeview Rd
Ste 2
Clearwater, FL 33756
Phone (727) 238-8003

2730 N McMullen Booth Rd
Ste 201
Clearwater, FL 33761
Phone (727) 210-2130

3251 N McMullen Booth Rd
Ste 102
Clearwater, FL 33761
Phone (727) 669-6242

34661 US Highway 19 N
Palm Harbor, FL 34684
Phone (727) 787-1350

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373241600000",
    "number": "1336362888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 LAKEVIEW RD 2",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563475",
            "telephone_number": "727-724-3985",
            "fax_number": "727-726-7553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LAKEVIEW RD 2",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563475",
            "telephone_number": "727-724-3985",
            "fax_number": "727-726-7553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A PETERSEN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2013-07-08",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-724-3985",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME54499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; 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.