Samuel Nolan Peterson, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

23642 Issued in OR

Practice address

1867 Williams Hwy
Ste. 105
Grants Pass, OR 97527-5854

Phone

(541) 474-4694

Fax

(541) 474-9590

NPI assigned

Nov 8, 2012

Sex

Male

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

Enrolled in OR, ID2 enrollments

Enrollment records 2

Specialty

Qualified Audiologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.3 of 100Reported as group

Quality

81.29

Promoting interoperability

100

Improvement activities

40

Cost

76.37

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058

  OR

  Medicare reassignment Care Compare group NPD
• Audiology Associates of Southern Oregon, Inc.

  • Audiologist
  • Grants Pass, OR
  • NPI 1912111980
  NPD (past)
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1352332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1720332968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1867 WILLIAMS HWY",
            "address_2": "STE. 105",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275854",
            "telephone_number": "541-474-4694",
            "fax_number": "541-474-9590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1867 WILLIAMS HWY",
            "address_2": "STE. 105",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275854",
            "telephone_number": "541-474-4694",
            "fax_number": "541-474-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SAMUEL",
        "middle_name": "NOLAN",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-08",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OR",
            "license": "23642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa M Persson, MS LPC
• Peter Shelby Bogard DO
• Marla Peters, MD
• Katie Petersen, CPM, LDM
• Paula M Peterson, LMT
• Kimberly Petetit
• Kyle M Pett, DMD
• Shawna Nichole Pfaendler
• Melissa Pfeifle, PHARMD
• Ashley Rhio Phaigh, LMT

• Audiologist in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Audiologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.