Madeline Peterson, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

134472654901 Issued in UT

Practice address

9340 S 700 E
Sandy, UT 84070-6203

Phone

(385) 468-4365

NPI assigned

Jul 10, 2023

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

State licenses

Practice roles

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.

• County of Salt Lake

  • Public Health or Welfare Agency
  • Salt Lake City, UT
  • NPI 1235260795
  NPD (past)

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1558049452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9340 S 700 E",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840706203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9340 S 700 E",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840706203",
            "telephone_number": "385-468-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MADELINE",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "UT",
            "license": "134472654901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Petersen, PTA
• Mathew Petersen, ABOC
• Clifton Kent Peterson, L.C.S.W.
• Holly Sue Peterson, LCSW
• James Wesley Peterson, PHARMD
• Marie Ann Peterson, DMD
• Ryan Peterson, CMHC
• Patrick Pfau, D.O.
• Kelly Jo Phillips, APRN
• Richard V Phillips

• Registered Dietitian in Sandy, UT
• Providers in Sandy, UT by specialty
• Registered Dietitian in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.