Justin Peterson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

10933355-1205 Issued in UT

Practice address

Budge General Surgery
1350 N 500 E
Logan, UT 84341-0001

Phone

(435) 716-1950

Fax

(435) 716-1950

NPI assigned

Jun 19, 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

Enrolled in UT

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

Specialty

General Surgery

Education

Eastern Virginia Medical School, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health Logan Regional Hospital Hospital, Logan, UT, CCN 460015

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: justin.peterson.1@16299.direct.athenahealth.com

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment Care Compare group NPD
• Ihc Health Services Inc

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Layton, UT
  • NPI 1205966439
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Orem, UT
  • NPI 1588601124
  NPD (past)

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

• Ihc Health Services Inc

  • General Acute Care Hospital
  • Logan, UT
  • NPI 1831108497
  Care Compare affiliation

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1811336241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "KY CLINIC GENERAL SURGERY",
            "address_2": "740 S LIMESTONE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360001",
            "telephone_number": "859-218-2568",
            "fax_number": "859-257-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BUDGE GENERAL SURGERY",
            "address_2": "1350 N 500 E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843410001",
            "telephone_number": "435-716-1950",
            "fax_number": "435-716-1950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Ky Clinic General Surgery",
            "address_2": "740 S Limestone",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360001",
            "country_code": "US",
            "telephone_number": "859-218-2568",
            "fax_number": "859-257-7603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JUSTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-19",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "IP1433",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "UT",
            "license": "10933355-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Elizabeth Peterson, FNP-BC
• Brent E. Peterson, D.C.
• Cameron Glade Peterson, M.D.
• David Erik Peterson, MD
• Frank E Peterson, M.D.
• Taylor V Pettit, DDS
• Langston Petty
• Tyler Pew, DO
• Curtis Nolan Phillips, PHD, PT
• Rebecca Phillips, MD

• Surgery Physician in Logan, UT
• Providers in Logan, UT by specialty
• Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.