Samantha Peterson, MS, RD, CSO

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

14200 W Celebrate Life Way
Goodyear, AZ 85338-3007

Phone

(623) 256-9920

NPI assigned

Jul 13, 2018

Last updated

Jul 13, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1531440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1497231369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12242 S 185TH AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853387959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14200 W CELEBRATE LIFE WAY",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853383007",
            "telephone_number": "623-256-9920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12242 S 185th Ave",
            "address_purpose": "LOCATION",
            "city": "Goodyear",
            "state": "AZ",
            "postal_code": "853387959",
            "country_code": "US",
            "telephone_number": "623-256-9920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SAMANTHA",
        "credential": "MS, RD, CSO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-13",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Troy Henry Peters, D.C.
• Abigail Peterson, DPT
• Alyssa Lynden Peterson
• Brandi Peterson
• Jennifer J Peterson, PMHNP-BC
• Wendy Pethybridge, MA, MS
• Timothy Owen Pfeiffer, DO
• Brett Robert Pfeifle, D.C.
• Christine Thienhuong Pham, MD
• Phong Pham, R.PH.

• Registered Dietitian in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Registered Dietitian in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; 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.