C M Peterson LLC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

APN000830 NV Issued in NV

Legal business name

C M PETERSON LLC

Practice address

1328 Fox Acres Dr
Las Vegas, NV 89134-0511

Phone

(702) 332-8353

Fax

(702) 921-6828

NPI assigned

Mar 26, 2008

Last updated

Apr 15, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christine M Peterson, APN

Title

Owner

Phone

(702) 332-8353

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1942472303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 FOX ACRES DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891340511",
            "telephone_number": "702-332-8353",
            "fax_number": "702-921-6828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 FOX ACRES DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891340511",
            "telephone_number": "702-332-8353",
            "fax_number": "702-921-6828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C M PETERSON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-332-8353",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NV",
            "license": "APN000830 NV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Medicine (Family Medicine) Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Geriatric Medicine (Family Medicine) Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.