David L. Peters, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

002404 Issued in MI

Practice address

611 W State St
Saint Johns, MI 48879-1451

Phone

(989) 224-6651

Fax

(989) 224-7024

NPI assigned

Jan 28, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1138406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366934400000",
    "number": "1376514372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W STATE ST",
            "address_2": "P.O.BOX 204",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488791451",
            "telephone_number": "989-224-6651",
            "fax_number": "989-224-7024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W STATE ST",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488791451",
            "telephone_number": "989-224-6651",
            "fax_number": "989-224-7024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "DAVID",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-28",
        "last_updated": "2013-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "002404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie A Patrick, RPH
• Amanda Patterson, L.L.P.C.
• Mary Ann Paxton
• PDS I Michigan Inc
• Pebble Creek Counseling LLC
• Edward Peters IV, OD
• Edward A Peters III, OD
• Zachary B Peters, OD
• Bailey Phinney
• Jessica Polen

• Optometrist in Saint Johns, MI
• Providers in Saint Johns, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.