Mary Peterson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R058495 Issued in GA

Practice address

5665 Peachtree Dunwoody Rd NE
Atlanta, GA 30342-1701

Phone

(404) 851-7324

Fax

(404) 843-2627

NPI assigned

Jan 9, 2007

Last updated

Jul 9, 2007By 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)

Enrolled

State licenses

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1588713796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5671 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 530",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303425000",
            "telephone_number": "404-257-1415",
            "fax_number": "404-851-1649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5665 PEACHTREE DUNWOODY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421701",
            "telephone_number": "404-851-7324",
            "fax_number": "404-843-2627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MARY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "R058495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judy Garrett Peterson, RPH
• Kathryn Marie Peterson, PHD
• Kristen Peterson, LAT, ATC
• Kristofor Mikael Peterson, DC
• Leigh Ann Peterson, LPC, CEAP, SAP
• Michael Peterson, AA
• Quendall Peterson, RPH
• Ryan Brent Peterson, M.D.
• Sara Alice Peterson, LPC
• Stephanie Peterson, PA-C

• Certified Registered Nurse Anesthetist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Certified Registered Nurse Anesthetist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.