Richard Boyd Peterson, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

19060 Issued in WV

Practice address

424 Division St
Suite 100
South Charleston, WV 25309-1400

Phone

(304) 766-4342

Fax

(304) 766-3541

NPI assigned

Sep 1, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Kanawha Valley Gastroenterology Associates, Inc.

  • Gastroenterology Physician
  • South Charleston, WV
  • NPI 1851473508
  NPD (past)

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932201985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 DIVISION ST",
            "address_2": "SUITE 100",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091400",
            "telephone_number": "304-766-4342",
            "fax_number": "304-766-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 DIVISION ST",
            "address_2": "SUITE 100",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091400",
            "telephone_number": "304-766-4342",
            "fax_number": "304-766-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "RICHARD",
        "middle_name": "BOYD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WV",
            "license": "19060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0088429000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosetta Perry
• Bradley S. Persinger, CRNA
• Freddie Dominick Persinger, D.O.
• Geana Persinger
• Mary Pertee
• Shelba Petrey
• Brianna Petry
• Brian Pettrey
• Christopher S Pettrey
• Pharmacy Associates, Inc

• Gastroenterology Physician in South Charleston, WV
• Providers in South Charleston, WV by specialty
• Gastroenterology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.