Samuel Peterson

Primary specialty

OptometristTaxonomy code 152W00000X

License

1704 Issued in NE

Practice address

625 N Lincoln Ave
York, NE 68467-2946

Phone

(402) 362-3313

NPI assigned

Oct 13, 2026

Last updated

Oct 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1791849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791849600000",
    "number": "1689579260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28297 478TH AVE",
            "city": "CANTON",
            "state": "SD",
            "postal_code": "570135866",
            "telephone_number": "605-214-5856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 N LINCOLN AVE",
            "city": "YORK",
            "state": "NE",
            "postal_code": "684672946",
            "telephone_number": "402-362-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SAMUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-10-13",
        "last_updated": "2026-10-13",
        "certification_date": "2026-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcus Paulson, D.C.
• Pamela Mae Pedersen, LADC
• Tanya Peters, LADC
• Barb Peterson
• Kamrie Lynn Peterson, APRN
• Bethany Phillips, PTA
• Addison Pinneo
• Andrew R. Pohlmeier, M. D.
• Prairie Spring Health LLC
• Kelly Price

• Optometrist in York, NE
• Providers in York, NE by specialty
• Optometrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.