Summerlin Surgical Associates

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

9665 Issued in NV

Legal business name

SUMMERLIN SURGICAL ASSOCIATES

Practice address

653 N Town Center Dr
Las Vegas, NV 89144-0514

Phone

(702) 256-7616

Fax

(702) 256-1481

NPI assigned

Nov 14, 2007

Organization subpart

No

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

Authorized official

Name

Kevin Petersen, MD

Title

Physician

Phone

(702) 256-7616

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1639350069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 N TOWN CENTER DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891440514",
            "telephone_number": "702-256-7616",
            "fax_number": "702-256-1481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 N TOWN CENTER DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891440514",
            "telephone_number": "702-256-7616",
            "fax_number": "702-256-1481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERLIN SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "702-256-7616",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NV",
            "license": "9665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summerlin Massagenv, LLC
• Summerlin Medical
• Summerlin Pelvic and Physical Therapy LLC
• Summerlin Psychology LLC
• Summerlin Smiles
• Summerlin Therapy & Couples Counseling
• Summerlin Vision Center Inc
• Donaldsu Summerlin
• Alexzandria Diane Monae Summers
• Ashley Summers

• Surgery Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Surgery Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.