Bendt P Petersen III, M.D.

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

00016728 Issued in AL

Practice address

6701 Airport Blvd Ste 100
Mobile, AL 36608-6701

Phone

(251) 607-6117

Fax

(251) 219-0746

NPI assigned

Apr 27, 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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Orthopedic Surgery

Education

University of Alabama School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Petersen Neurospine PLLCGroup PAC ID 6204268022, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• USA Health HCA Providence Hospital, LLC Hospital, Mobile, AL, CCN 010090
• Mobile Infirmary Medical Center Hospital, Mobile, AL, CCN 010113
• Thomas Hospital Hospital, Fairhope, AL, CCN 010100

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Petersen Neurospine, PLLC

  • Orthopaedic Surgery of the Spine Physician
  • Mobile, AL
  • NPI 1639710882
  Medicare reassignment Care Compare group NPD Authorized official

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

• Gulf Health Hospitals, Inc

  • General Acute Care Hospital
  • Fairhope, AL
  • NPI 1447303227
  Care Compare affiliation
• Mobile Infirmary Association

  • General Acute Care Hospital
  • Mobile, AL
  • NPI 1558364802
  Care Compare affiliation
• USA Health HCA Providence Hospital LLC

  • General Acute Care Hospital
  • Mobile, AL
  • NPI 1992489223
  Care Compare affiliation

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1477510915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 AIRPORT BLVD",
            "address_2": "BUILDING D SUITE 100",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36608",
            "telephone_number": "251-607-6117",
            "fax_number": "251-219-0746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 AIRPORT BLVD STE 100",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366086701",
            "telephone_number": "251-607-6117",
            "fax_number": "251-219-0746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "BENDT",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "AL",
            "license": "00016728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "512-30874",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "249129",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Morris Peters, MSOTR/L
• Kelsey Nutt Peters, DDS
• Melissa Leigh Peters, MD
• Brandon M. Peters,
• Petersen Neurospine, PLLC
• Madison Petersen, MD
• Dylan Peterson
• Erin Peterson
• Sarah Lisa Peterson, APRN, CNP
• Petrey Chiropractic LLC

• Orthopaedic Surgery of the Spine Physician in Mobile, AL
• Providers in Mobile, AL by specialty
• Orthopaedic Surgery of the Spine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.