Stephen Eugene Peterson, M.D.

Primary specialty

Forensic Psychiatry PhysicianTaxonomy code 2084F0202X

License

04-21932 Issued in KS

Practice address

428 W 42ND St
Kansas City, MO 64111-3176

Phone

(816) 842-2500

Fax

(816) 842-9980

NPI assigned

Mar 8, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Logan & Peterson, PC

  • Medical Specialty Clinic/Center
  • Kansas City, MO
  • NPI 1063613057
  NPD (past) Authorized official

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

{
    "created_epoch": "1362700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362700800000",
    "number": "1801137377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 W 42ND ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113176",
            "telephone_number": "816-842-2500",
            "fax_number": "816-842-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 W 42ND ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113176",
            "telephone_number": "816-842-2500",
            "fax_number": "816-842-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "STEPHEN",
        "middle_name": "EUGENE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-08",
        "last_updated": "2013-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "MO",
            "license": "R5P78",
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "KS",
            "license": "04-21932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Brooke Peterson, PHARMD
• Louis Hayward Peterson, MD
• Nicole Kathleen Peterson, PTA
• Olivia Audrey Peterson
• Paul Eric Peterson, BS
• William Peterson, MD
• Michael Petite
• Toni Petralie
• Cynthia Spiliopoulou Petrie, DDS
• Diane Renee Petrie, F.N.P.-BC

• Forensic Psychiatry Physician in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Forensic Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; 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.