Charles S Peterson MD PC

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

28027 Issued in AZ

Legal business name

CHARLES S PETERSON MD PC

Practice address

5111 N Scottsdale Rd
Suite 101
Scottsdale, AZ 85250-7075

Phone

(480) 558-3744

Fax

(480) 558-3801

NPI assigned

Jun 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Charles S Peterson, MD

Title

Owner President

Phone

(480) 558-3744

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228348800000",
    "number": "1548465750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2507",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852142507",
            "telephone_number": "480-558-3744",
            "fax_number": "480-558-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 N SCOTTSDALE RD",
            "address_2": "SUITE 101",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852507075",
            "telephone_number": "480-558-3744",
            "fax_number": "480-558-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES S PETERSON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2008-12-04",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "480-558-3744",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "AZ",
            "license": "28027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Raymond Igor Charles, D.C.
• Tryphose Charles, DMD
• Roshawnda Charley
• Sara Charney, MS, CCC-SLP

• Sports Medicine (Family Medicine) Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Sports Medicine (Family Medicine) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; 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.