David P Petersen, MD

Primary specialty

Surgery of the Hand (Surgery) PhysicianTaxonomy code 2086S0105X

License

4301039798 Issued in MI

Practice address

1111 Leffingwell Ave NE
Suite 200
Grand Rapids, MI 49525-6406

Phone

(616) 957-4263

Fax

(616) 957-0444

NPI assigned

Aug 17, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Michigan Hand Center, PLC

  • Surgery of the Hand (Surgery) Physician
  • Grand Rapids, MI
  • NPI 1386690436
  NPD (past)
• Orthopaedic Associates of Grand Rapids, PC

  • Orthopaedic Surgery Physician
  • Grand Rapids, MI
  • NPI 1023021300
  NPD (past)

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208995200000",
    "number": "1558353540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 LEFFINGWELL AVE NE",
            "address_2": "SUITE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256406",
            "telephone_number": "616-957-4263",
            "fax_number": "616-957-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 LEFFINGWELL AVE NE",
            "address_2": "SUITE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256406",
            "telephone_number": "616-957-4263",
            "fax_number": "616-957-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "DAVID",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2008-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301039798",
            "primary": false
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "MI",
            "license": "4301039798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4096458",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kara Peters
• Raneithiah Peters
• Robert J Peters, OD
• Ryan A Peters, DO
• Courtney Petersen
• Hanna Louise Petersen
• Jennifer Petersen, LLMSW
• Marquita Petersen
• Shelby Petersen
• Katie Peterson-Benson, MA, LPC

• Surgery of the Hand (Surgery) Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Surgery of the Hand (Surgery) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.