Your Health Home PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

48485 Issued in AZ

Legal business name

YOUR HEALTH HOME PLLC

Practice address

2035 Mesquite Ave
Suite C
Lake Havasu City, AZ 86403-5894

Phone

(928) 680-3343

Fax

(928) 680-3342

NPI assigned

Dec 10, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Robert D Peterson, M.D.

Title

Owner/Member

Phone

(928) 680-3343

Specialties & licenses 1

Addresses

Other identifiers 2

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8307/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394668800000",
    "number": "1609207075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1969",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864051969",
            "telephone_number": "928-680-3343",
            "fax_number": "928-680-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 MESQUITE AVE",
            "address_2": "SUITE C",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035894",
            "telephone_number": "928-680-3343",
            "fax_number": "928-680-3342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR HEALTH HOME PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-10",
        "last_updated": "2014-03-13",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "928-680-3343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "48485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PLLC REGISTRATION NUMBER",
            "identifier": "P-18894563",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "885211",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mahesh Yahdev, LDO
• Olivia Yambem, M.D.
• Jason Yole, DMD
• Tami Rae Young
• Haylee Younis, FNP-C
• Timothy A Youso, PHARM D
• Zeeshan Afzal Zahid, MD
• Connor Zehak, DMD
• Mackenzie Rae Zemojtel, SLPA
• Marc Herbert Zimmerman, M.D.

• Internal Medicine Physician in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.