NPIMap

Individual provider Active NPI

Cecily Karen Peterson, MD

  • Internal Medicine Physician
  • Tacoma, WA
National Provider Identifier
1447222369
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
12181R Issued in LA
Practice address
Madigan Army Medical Center
9040 Reid Street
Tacoma, WA 98431-0001
Phone
(253) 968-0208
Fax
(253) 968-1168
NPI assigned
Feb 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 12181R LA Primary

Addresses

Primary practice location

Madigan Army Medical Center
9040 Reid Street
Tacoma, WA 98431-0001

Mailing address

4029 Muirfield LN SE
Olympia, WA 98501-5188
Phone (360) 459-5013

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100622000592 NC Practitioner - Internal Medicine 7214068196 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Geisel School of Medicine at Dartmouth, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600

3024 Pickett Rd
Durham, NC 27705-6006
Phone (919) 490-9800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12181RLAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Affiliated Physicians, Inc. Internal Medicine CurrentSince Sep 12, 2016 Accepting new patients
Duke University Health System, Inc. Internal Medicine CurrentSince Jun 22, 2010 Accepting new patients
Duke University Health System, Inc. CurrentSince Jun 22, 2010 Accepting new patients
Duke University Affiliated Physicians, Inc. CurrentSince Sep 12, 2016 Accepting new patients
Duke University Affiliated Physicians, Inc. Internal Medicine Current Accepting new patients

Locations

1821 Hillandale Rd
Ste 24B
Durham, NC 27705
Phone (919) 383-4355

3004 Tower Blvd
Durham, NC 27707
Phone (919) 236-1882

3024 Pickett Rd
Durham, NC 27705
Phone (919) 490-9800

5716 Fayetteville Rd
Durham, NC 27713
Phone (919) 572-1868

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

1901 Hillandale Rd
Ste D
Durham, NC 27705
Phone (919) 383-4355

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

7200 Creedmoor Rd
Ste 208
Raleigh, NC 27613
Phone (919) 327-1650

7021 Harps Mill Rd
Ste 100
Raleigh, NC 27615
Phone (919) 576-8480

Interoperability endpoints

  • Direct secure messaging: cpeterson66867@direct.medicine.duke.edu

Organizations & group practices 5

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447222369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4029 MUIRFIELD LN SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985015188",
            "telephone_number": "360-459-5013",
            "fax_number": "253-968-1168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CENTER",
            "address_2": "9040 REID STREET",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-0208",
            "fax_number": "253-968-1168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CECILY",
        "middle_name": "KAREN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "12181R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.