Hubert Peterson, MD

Primary specialty

Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X

License

04-22995 Issued in KS

Practice address

1436 N Western Ave
Liberal, KS 67901-2212

Phone

(620) 626-8500

NPI assigned

Jan 28, 2006

Sex

Male

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

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.

• Cimarron Pathology PA

  • Clinical Medical Laboratory
  • Liberal, KS
  • NPI 1629049648
  NPD (past) Authorized official
• Liberal Family Chiropractic Inc

  • Chiropractor
  • Liberal, KS
  • NPI 1245485887
  NPD (past)

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

{
    "created_epoch": "1138406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1891766812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1258",
            "city": "LIBERAL",
            "state": "KS",
            "postal_code": "679051258",
            "telephone_number": "620-626-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 N WESTERN AVE",
            "city": "LIBERAL",
            "state": "KS",
            "postal_code": "679012212",
            "telephone_number": "620-626-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "HUBERT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-28",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KS",
            "license": "04-22995",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "KS",
            "license": "04-22995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pegasus Emergency Physicians, LLC
• Livan Perez
• Perlita M. Dutton, DDS, PA
• Shawn Peters-Blascyk
• Keitha Eva Peters
• Vera Elena Petrovic
• Andy Phan
• Peter Phan, M.D.
• Tanya Jan Pittman, M.D.
• Roman Pohorecki, MD

• Clinical Pathology/Laboratory Medicine Physician in Liberal, KS
• Providers in Liberal, KS by specialty
• Clinical Pathology/Laboratory Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.