Jon T Peterson, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

0101052027 Issued in VA

Practice address

2871 Greensboro Rd
Martinsville, VA 24112-8108

Phone

(276) 638-2273

NPI assigned

Jul 27, 2006

Last updated

Aug 22, 2022By 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 3

Medicare fee-for-service enrollment

Enrolled in VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Preventive MedicineAlso: Emergency Medicine

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr. Jons Urgent Care Center, LLCGroup PAC ID 5294873378, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11587/brand/1/csg/1/fhir/r4

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.

• Dr. Jon's Urgent Care Center, LLC

  • General Practice Physician
  • Martinsville, VA
  • NPI 1639403769
  Medicare reassignment Care Compare group NPD Authorized official
• Martinsville Family Care LLC

  • Primary Care Clinic/Center
  • Martinsville, VA
  • NPI 1730076761
  Medicare reassignment NPD Authorized official
• Virginia Emergency Group LLC

  • Emergency Medicine Physician
  • Petersburg, VA
  • NPI 1487816369
  NPD (past)
• Virginia Emergency Physicians LLP

  • Emergency Medicine Physician
  • Richmond, VA
  • NPI 1114942182
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Public Hospital Dist No 1 Skagit

  dba Skagit Valley Hospital

  • General Acute Care Hospital
  • Mount Vernon, WA
  • NPI 1053357244
  Care Compare affiliation

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1407870975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2871 GREENSBORO RD",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241128108",
            "telephone_number": "276-638-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2871 GREENSBORO RD",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241128108",
            "telephone_number": "276-638-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JON",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101052027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8906672",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407870975",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010064325",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Ann Pedersen, CPNP
• Iaisha Penn
• Miesha Penn, LPC
• Brandy Nicole Perkins, L.P.C
• Richard S Perren, M.D.
• PHC - Martinsville Inc
• PHC - Martinsville Inc (Home Care of Memorial Hospital)
• PHC-Martinsville Inc
• PHC-Martinsville, Inc. (Memorial Hospital of Martinsville and Henry County)
• Jennifer Walker Phelps, NURSE PRACTITIONER

• Emergency Medicine Physician in Martinsville, VA
• Providers in Martinsville, VA by specialty
• Emergency Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.