Theodore Thomas Peters, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

F4371 Issued in TX

Practice address

2535 Ira E Woods Avenue
Grapevine, TX 76051-3930

Phone

(817) 481-2121

Fax

(817) 488-4493

NPI assigned

Jun 21, 2005

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

Interoperability endpoints

• Direct secure messaging: ted.peters.1@18148.direct.athenahealth.com

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1922004472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 IRA E WOODS AVENUE",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513930",
            "telephone_number": "817-481-2121",
            "fax_number": "817-488-4493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 IRA E WOODS AVENUE",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513930",
            "telephone_number": "817-481-2121",
            "fax_number": "817-488-4493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4501 Heritage Trace Parkway, Suite 101",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "762448940",
            "country_code": "US",
            "telephone_number": "817-481-2121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "THEODORE",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "F4371",
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "TX",
            "license": "F4371",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "099325501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "82X722",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda B Perrin, RN, MSN, CPNP
• Delisa Deutsch Perry, MS, LPC-S
• Personic Woundcare PLLC
• Jennifer Lee Peters
• Pat Andrew Peters, MD
• Patrick Thien an Pham
• Philip a. Moore, M.D., P.a.
• Aminat Y Phillips, NP
• Phoenix One Health Solutions LLC
• Sylvia Lois Pierce

• Orthopaedic Surgery Physician in Grapevine, TX
• Providers in Grapevine, TX by specialty
• Orthopaedic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; 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.