Individual provider Active NPI

Timothy Douglas Peters, M.D.

  • Rheumatology Physician
  • Redding, CA
National Provider Identifier
1417909847
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
G76391 Issued in CA
Practice address
2510 Airpark Dr
Suite #305
Redding, CA 96001-2449
Phone
(530) 241-8822
Fax
(530) 241-0746
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X G76391 CA Primary

Addresses

Primary practice location

2510 Airpark Dr
Suite #305
Redding, CA 96001-2449

Mailing address

2510 Airpark Dr
Suite #305
Redding, CA 96001-2449
Phone (530) 241-8822

Other identifiers 1

IdentifierTypeStateIssuer
00G763910MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250225000281 CA Order and Referring Only - Hospice/Palliative CarePractitioner - Hospice/Palliative Care 3971672775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G76391CAMDRheumatology Physician

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bristol Hospice - ReddingRedding, CA, CCN 751664 Hospice Contracted Managing Employee Oct 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1417909847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 AIRPARK DR",
            "address_2": "SUITE #305",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012449",
            "telephone_number": "530-241-8822",
            "fax_number": "530-241-0746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 AIRPARK DR",
            "address_2": "SUITE #305",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012449",
            "telephone_number": "530-241-8822",
            "fax_number": "530-241-0746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "TIMOTHY",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "G76391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G763910",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.