Celeste V Peterson, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

827 Issued in TN

Practice address

222 Oak St
Mountain City, TN 37683-1526

Phone

(423) 727-6319

Fax

(423) 727-4164

NPI assigned

Jun 14, 2005

Sex

Female

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264723200000",
    "number": "1942205349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378570850",
            "telephone_number": "423-727-6319",
            "fax_number": "423-727-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 OAK ST",
            "city": "MOUNTAIN CITY",
            "state": "TN",
            "postal_code": "376831526",
            "telephone_number": "423-727-6319",
            "fax_number": "423-727-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CELESTE",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-14",
        "last_updated": "2010-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3300550",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "4085169",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ben Deal Parrish, O.D.
• Kennedy Nicole Parrott, PA-C
• William S Payne, LPC
• Joshua H Perkins, PA
• Pamela Grace Peters, OTR/L
• Jennifer Lynn Phillippi, BS
• Penelope Dawn Plante, NURSE PRACTITIONER
• Rachel A Poteet, LCSW
• Dorothy M Proffitt, RPH
• Adam Michael Qualls, DMD

• Family Medicine Physician in Mountain City, TN
• Providers in Mountain City, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; 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.