Active NPI
David Michael Peterson, RPH
- Pharmacist
- Butte, MT
National Provider Identifier
1386070647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PHA-PHA-2883
- Practice address
- 1200 W Gold St
Butte, MT 59701-2110 - Phone
- (406) 494-1075
- NPI assigned
- Sep 18, 2013
- Last updated
- Sep 18, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PHA-PHA-2883 | MT | Primary |
Addresses
Primary practice location
1200 W Gold St
Butte, MT 59701-2110
Mailing address
1200 W Gold St
Butte, MT 59701-2110
Phone (406) 494-1075
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PHA-PHA-LIC-2883 | Other | MT | PHARMACY LIC # |
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)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PHA-PHA-2883 | MT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379462400000",
"number": "1386070647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 W GOLD ST",
"city": "BUTTE",
"state": "MT",
"postal_code": "597012110",
"telephone_number": "406-494-1075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 W GOLD ST",
"city": "BUTTE",
"state": "MT",
"postal_code": "597012110",
"telephone_number": "406-494-1075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "DAVID",
"middle_name": "MICHAEL",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-18",
"last_updated": "2013-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MT",
"license": "PHA-PHA-2883",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LIC #",
"identifier": "PHA-PHA-LIC-2883",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Butte, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.