Individual provider Active NPI

Joseph Peterson, M.D.

  • Obstetrics & Gynecology Physician
  • Pensacola, FL
National Provider Identifier
1770769820
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME0097396 Issued in FL
Practice address
5045 Carpenter Creek Dr
Pensacola, FL 32503-2521
Phone
(850) 416-2400
Fax
(850) 416-2467
NPI assigned
Jan 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME0097396 FL Primary

Addresses

Primary practice location

5045 Carpenter Creek Dr
Pensacola, FL 32503-2521

Mailing address

PO Box 2699
Pensacola, FL 32513-2699
Phone (850) 416-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080505000694 FL Practitioner - Obstetrics/Gynecology 8426137209 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Loma Linda University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

5045 Carpenter Creek Dr
Pensacola, FL 32503-2521
Phone (850) 416-2400

Hospital & facility affiliations

  • Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0097396FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Escambia Community Clinics, Inc CurrentSince Mar 7, 2016 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Nov 1, 2015 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Nov 1, 2015 Accepting new patients
Escambia Community Clinics Inc CurrentSince Mar 7, 2016 Accepting new patients
Sacred Heart Health System Inc CurrentSince Nov 28, 2017 Accepting new patients
Florida Medical Practice Plan Inc CurrentSince Mar 1, 2008 Accepting new patients
Escambia Community Clinics Inc Current Accepting new patients
Sacred Heart Health System, Inc. CurrentSince Nov 28, 2017 Accepting new patients
Sacred Heart Health System, Inc. Current Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology Current Accepting new patients
Sacred Heart Health System, Inc. Past Accepting new patients

Locations

1399 Country Club Rd
Gulf Breeze, FL 32563
Phone (850) 416-4709

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

5520 Stewart St
Milton, FL 32570
Phone (850) 891-9433

4501 N Davis Hwy
Ste A
Pensacola, FL 32503
Phone (850) 476-9000

5045 Carpenter Creek Dr
Pensacola, FL 32503
Phone (850) 416-2400

14 W Jordan St
Pensacola, FL 32501
Phone (800) 436-4630

2315 W Jackson St
Pensacola, FL 32505
Phone (850) 495-3955

1657 Trinity Dr
Pensacola, FL 32504
Phone (850) 416-2400

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

4449 Meandering Way
Tallahassee, FL 32308
Phone (850) 201-0956

Interoperability endpoints

  • Direct secure messaging: joseph.peterson.2@9582.direct.athenahealth.com

Organizations & group practices 11

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1770769820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699",
            "telephone_number": "850-416-2400",
            "fax_number": "850-416-2467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5045 CARPENTER CREEK DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032521",
            "telephone_number": "850-416-2400",
            "fax_number": "850-416-2467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-18",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME0097396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.