Craig Peterson

Primary specialty

SpecialistTaxonomy code 174400000X

License

8143 Issued in NY

Practice address

207 Pine St
Syracuse, NY 13210-1137

Phone

(315) 476-3176

Fax

(315) 476-0171

NPI assigned

Oct 20, 2006

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 NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Peterson & Nellis Physical Therapy PC

  • Specialist
  • Syracuse, NY
  • NPI 1033291802
  Medicare reassignment

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297296000000",
    "number": "1891877445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 PINE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101137",
            "telephone_number": "315-476-3176",
            "fax_number": "315-476-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 PINE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101137",
            "telephone_number": "315-476-3176",
            "fax_number": "315-476-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CRAIG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2011-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "8143",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marsha Peters
• Shelly Lynn Peters, PMHNP-BC
• Peterson & Nellis Physical Therapy PC
• Brittany Peterson, LPN
• Christopher Lee Peterson
• Iva Kay Peterson, RN
• Jatia Peterson, LMSW
• Jennifer Peterson, FNP-C
• Scott Michael Peterson, ATC
• Rosena Petit-Frere, CRNA

• Specialist in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.