Robert D Peterson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

48485 Issued in AZ

Practice address

2035 Mesquite Ave
Suite C
Lake Havasu City, AZ 86403-5894

Phone

(928) 680-3343

Fax

(928) 680-3342

NPI assigned

Dec 9, 2005

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: robert.peterson.1@8307.direct.athenahealth.com

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1831174093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1969",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864051969",
            "telephone_number": "928-680-3343",
            "fax_number": "928-680-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 MESQUITE AVE",
            "address_2": "SUITE C",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035894",
            "telephone_number": "928-680-3343",
            "fax_number": "928-680-3342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ROBERT",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "48485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Theresa Perkins
• Barbara Jean Perry, MD
• Melissa Peru
• Kishore Perumandla
• Brian Peters, MD
• Petersons Home Care Inc
• PHC-Lake Havasu Inc
• Douglas George Pheling, MA
• Philip a St Raymond MD PLLC
• Cassidy Phoenix

• Internal Medicine Physician in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; 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.