Brian Walter Petersen, D.O.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

2291 Issued in TN

Practice address

482 Interstate Dr Ste 102
Manchester, TN 37355-3485

Phone

(931) 488-8700

Fax

(931) 735-6456

NPI assigned

May 28, 2007

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 TN

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

Orthopedic Surgery

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coffee Medical Group LLCGroup PAC ID 1850208794, 22 clinicians

Coffee County Hospital Group IncGroup PAC ID 1456317783, 87 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adoration Home Health, LLC Home health agency, Madison, TN, CCN 447581
• Amedisys Home Care Home health agency, Winchester, TN, CCN 447238
• Unity Medical Center Hospital, Manchester, TN, CCN 440007
• Vanderbilt Tullahoma-Harton Hospital Hospital, Tullahoma, TN, CCN 440144
• Vanderbilt Bedford Hospital Hospital, Shelbyville, TN, CCN 440137
• Southern Tennessee Regional Health System Winchest Hospital, Winchester, TN, CCN 440058
• Lincoln Medical Center Hospital, Fayetteville, TN, CCN 440102

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brian.petersen@mcrhc.eclinicaldirectplus.com
• Direct secure messaging: hmcmqi8927@yourcarecommunity.org

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.

• Coffee Medical Group LLC

  • Rural Acute Care Hospital
  • Manchester, TN
  • NPI 1013969179
  Medicare reassignment Care Compare group NPD
• Saint Thomas Medical Partners

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1437194669
  Medicare reassignment NPD
• Coffee Medical Group LLC

  • Rural Health Clinic/Center
  • Manchester, TN
  • NPI 1700192028
  Care Compare group NPD (past)
• Coffee Medical Group LLC

  • Rural Health Clinic/Center
  • Manchester, TN
  • NPI 1043537046
  NPD
• Evanston Clinic Corp

  • Family Medicine Physician
  • Evanston, WY
  • NPI 1013916519
  NPD (past)

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

• Adoration Home Health, LLC

  • Home Health Agency
  • Madison, TN
  • NPI 1790161321
  Care Compare affiliation
• Coffee Medical Group LLC

  • Rural Acute Care Hospital
  • Manchester, TN
  • NPI 1013969179
  Care Compare affiliation
• Comprehensive Home Healthcare Services LLC

  • Home Health Agency
  • Winchester, TN
  • NPI 1730137415
  Care Compare affiliation
• HH Health System - Lincoln Inc

  • Rural Acute Care Hospital
  • Fayetteville, TN
  • NPI 1255066460
  Care Compare affiliation
• Southern Tennessee Medical Center LLC

  • General Acute Care Hospital
  • Winchester, TN
  • NPI 1467408781
  Care Compare affiliation
• Vanderbilt Bedford Hospital, LLC

  • General Acute Care Hospital
  • Shelbyville, TN
  • NPI 1487253449
  Care Compare affiliation
• Vanderbilt Coffee Hospital, LLC

  • General Acute Care Hospital
  • Tullahoma, TN
  • NPI 1831798719
  Care Compare affiliation

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

{
    "created_epoch": "1180310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1861693095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MOSBY CT",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371607179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 INTERSTATE DR STE 102",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373553485",
            "telephone_number": "931-488-8700",
            "fax_number": "931-735-6456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "730 Kings Ln",
            "address_purpose": "LOCATION",
            "city": "Tullahoma",
            "state": "TN",
            "postal_code": "373885371",
            "country_code": "US",
            "telephone_number": "931-841-9200",
            "fax_number": "931-841-9216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "BRIAN",
        "middle_name": "WALTER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-28",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "2291",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WY",
            "license": "TL1160",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Sitz Patterson, APN
• Catherine Marie Patterson, PA-C
• Judith Anderson Patterson
• Paul E. Honeycutt, DDS
• Misty Niroca Paul
• Denise Pettinger, FNP
• Jaime Phillips, PMHNP, RN
• Kathryn A Phillips, MSNRNCS
• Mariah Shaneil Phillips, RN
• Alysa Posey, RN

• Orthopaedic Surgery Physician in Manchester, TN
• Providers in Manchester, TN by specialty
• Orthopaedic Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; 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.