Active NPI
Heather Anne Peterson, M.D.
- Pediatrics Physician
- Cary, NC
National Provider Identifier
1366425902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2006-00675
- Practice address
- 97 Cornerstone Dr
Cary, NC 27519-8403 - Phone
- (919) 460-0993
- Fax
- (919) 481-3952
- NPI assigned
- Nov 29, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2006-00675 | NC | Primary |
Addresses
Primary practice location
97 Cornerstone Dr
Cary, NC 27519-8403
Mailing address
1108 Tamworth Hill LN
Cary, NC 27519-8860
Phone (919) 651-0189
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006-00675 | NC | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Raleigh Durham Medical Group PA | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315353600000",
"number": "1366425902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1108 TAMWORTH HILL LN",
"city": "CARY",
"state": "NC",
"postal_code": "275198860",
"telephone_number": "919-651-0189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "97 CORNERSTONE DR",
"city": "CARY",
"state": "NC",
"postal_code": "275198403",
"telephone_number": "919-460-0993",
"fax_number": "919-481-3952"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "HEATHER",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-29",
"last_updated": "2011-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "2006-00675",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cary, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.