Stacy Peterson, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

34007398 Issued in OH

Practice address

1997 Miamisburg Centerville Rd
Dayton, OH 45459-3811

Phone

(800) 514-1494

NPI assigned

Aug 21, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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.

• North Shore Center for Orthopedic Surgery & Sports Medicine LLC

  • Orthopaedic Surgery Physician
  • Danvers, MA
  • NPI 1891447173
  NPD Authorized official
• Peterson Sports Therapy LLC

  • Physical Therapist
  • Danvers, MA
  • NPI 1104410216
  NPD Authorized official
• Peterson Orthopedics LLC

  • Orthopaedic Surgery Physician
  • Danvers, MA
  • NPI 1306598206
  NPD
• Samaritan Emergency Corp

  • Emergency Medicine Physician
  • Dayton, OH
  • NPI 1922084136
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640995200000",
    "number": "1952416489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 BOXWOOD LN",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151365",
            "telephone_number": "401-829-7256",
            "fax_number": "978-774-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1997 MIAMISBURG CENTERVILLE RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454593811",
            "telephone_number": "800-514-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "STACY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2022-01-01",
        "certification_date": "2022-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34007398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry L Peterson, RN
• Lillian J Peterson, LISW-S
• Michelle Peterson, HEALTH AID
• Sarah Peterson, BS.
• Shannon Peterson, CDCA
• William Peterson II
• Lila Petett Talbott, RN
• Haley Jean Petges, RD
• Angela Petitt
• Petra Medicare Transportation Inc

• Emergency Medicine Physician in Dayton, OH
• Providers in Dayton, OH by specialty
• Emergency Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2022; 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.