Individual provider Active NPI

Brian Peters, MD

  • Emergency Medicine Physician
  • Lake Havasu City, AZ
National Provider Identifier
1477590537
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
28026 Issued in AZ
Practice address
101 Civic Center LN
Lake Havasu City, AZ 86403-5607
Phone
(928) 453-0150
NPI assigned
May 31, 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
Emergency Medicine Physician 207P00000X 28026 AZ Primary

Addresses

Primary practice location

101 Civic Center LN
Lake Havasu City, AZ 86403-5607

Mailing address

1205 W Remuda Way
Payson, AZ 85541-5209
Phone (480) 221-1275

Other identifiers 1

IdentifierTypeStateIssuer
495102MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 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

Enrollment IDStateProvider typePAC IDDetails
I20040430001293 AZ Practitioner - Emergency MedicinePractitioner - General SurgeryPractitioner - Vascular Surgery 8628066552 Reassigns benefits to 3 organizations
I20181101002898 TX Practitioner - Emergency Medicine 8628066552 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
San Carlos Apache Healthcare Corporation CurrentSince Aug 28, 2018 Accepting new patients
San Carlos Apache Healthcare Corporation Current Accepting new patients
La Paz Regional Hospital Inc Current Accepting new patients
Sunset Emergency Physicians LLC Emergency Medicine CurrentSince Jun 1, 2018 Accepting new patients
Emcare Physician Providers, Inc Emergency Medicine Past Accepting new patients
Willard Emergency Physicians Emergency Medicine Past Accepting new patients
University Physicians Healthcare Past Accepting new patients
Emcare Physician Providers, Inc Emergency Medicine Past Accepting new patients
London Bridge Emergency Physicians Emergency Medicine Past Accepting new patients
Grand Canyon State Inpatient Services Past Accepting new patients

Locations

1200 W Mohave Rd
Parker, AZ 85344
Phone (928) 669-7300

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

Interoperability endpoints

  • Direct secure messaging: brianpeters@lprh.medalliesdirect.net

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1477590537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 W REMUDA WAY",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855415209",
            "telephone_number": "480-221-1275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CIVIC CENTER LN",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035607",
            "telephone_number": "928-453-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "28026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495102",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.