Active NPI
I Eugene Peterson, M.D.
- Otolaryngology Physician
- Des Moines, IA
National Provider Identifier
1922094952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 18425
- Practice address
- 3901 Ingersoll Ave
Des Moines, IA 50312-3505 - Phone
- (515) 274-9135
- Fax
- (515) 274-3107
- NPI assigned
- Sep 26, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 18425 | IA | Primary |
Addresses
Primary practice location
3901 Ingersoll Ave
Des Moines, IA 50312-3505
Mailing address
PO Box 4907
Des Moines, IA 50306-4907
Phone (515) 241-5785
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18425 | IA | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1922094952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4907",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503064907",
"telephone_number": "515-241-5785",
"fax_number": "515-241-4415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 INGERSOLL AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503123505",
"telephone_number": "515-274-9135",
"fax_number": "515-274-3107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "I",
"middle_name": "EUGENE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-26",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IA",
"license": "18425",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.