Ryan Peterson OD, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

RYAN PETERSON OD, INC.

Practice address

5691 Rickenbacker Rd
Nellis Afb, NV 89191-7052

Phone

(702) 644-6671

NPI assigned

Oct 10, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Ryan Kent Peterson, OD

Title

President/Optometrist

Phone

(702) 299-6200

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539129600000",
    "number": "1730654385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 BARONET DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891388016",
            "telephone_number": "702-683-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5691 RICKENBACKER RD",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891917052",
            "telephone_number": "702-644-6671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN PETERSON OD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-10",
        "last_updated": "2018-10-10",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "PRESIDENT/OPTOMETRIST",
        "authorized_official_telephone_number": "702-299-6200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mellissa Ruiz
• Krystl Gayle Rumen, WHNP
• Elliot Runge, DO
• Joaniqua Rutherford, DENTAL ASSISTANT
• Ryan Peterson O.D., Inc.
• Eda Saatciler, DNP-FNP, RN-BC, APN
• Leslie Hauser Sadler, LCSW, ACSW
• Adriana Cristina Saenz
• Safe Co-Management Inc
• Theodore R Saitz, MD

• Optometrist in Nellis Afb, NV
• Providers in Nellis Afb, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; 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.