Joseph Michael Petersen, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

35078810 Issued in OH

Practice address

222 N 5TH St
Suite 205
Martins Ferry, OH 43935-1582

Phone

(740) 633-6573

Fax

(740) 633-6574

NPI assigned

Jan 11, 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432684800000",
    "number": "1881744167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 EOFF ST",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260033823",
            "telephone_number": "304-234-8663",
            "fax_number": "304-234-8960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 N 5TH ST",
            "address_2": "SUITE 205",
            "city": "MARTINS FERRY",
            "state": "OH",
            "postal_code": "439351582",
            "telephone_number": "740-633-6573",
            "fax_number": "740-633-6574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "JOSEPH",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2015-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WV",
            "license": "13832",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35078810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0124384000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2262108",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenda L Palmer, CMA
• Johnette Nicole Papp, RN
• Kristin Jo Parker
• Susan Kay Parker, MSW LISW
• Chevy Del Raya Pavell, BSW
• Harold L Pickens, O.D.
• Plastic Surgery Inc
• Podiatry Associates of Eastern Oh LLC
• Podiatry Associates of Eastern Ohio, LLC
• Michael Lee Proctor

• Surgery Physician in Martins Ferry, OH
• Providers in Martins Ferry, OH by specialty
• Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; 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.