C S Peters OD, PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

OP0001109 Issued in FL

Legal business name

C S PETERS OD, PA

Practice address

111 N John Sims Pkwy
Valparaiso, FL 32580-1005

Phone

(850) 678-1722

NPI assigned

Oct 26, 2010

Organization subpart

No

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

Authorized official

Name

C S Peters

Title

President

Phone

(850) 678-1722

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291248000000",
    "number": "1477853364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N JOHN SIMS PKWY",
            "city": "VALPARAISO",
            "state": "FL",
            "postal_code": "325801005",
            "telephone_number": "850-678-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N JOHN SIMS PKWY",
            "city": "VALPARAISO",
            "state": "FL",
            "postal_code": "325801005",
            "telephone_number": "850-678-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C S PETERS OD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-26",
        "last_updated": "2010-12-02",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "C",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-678-1722"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OP0001109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084488800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wyndal K Blankenship, MD
• Annette Brabham, O.D.
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• Sharon Marie Branscome, O.D.
• Mary Catherine Brogdon, L.P.N
• Thaddaeus R Castaneda, M.D.
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• Vanessa Natasha D'Aquin, APRN
• Donald B. Schak Sr., M.D., PA
• Marion Worth Duncan III

• Optometrist in Valparaiso, FL
• Providers in Valparaiso, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.