Individual provider Active NPI

Joshua Ryan Peterson, ARNP

  • Family Nurse Practitioner
  • Tempe, AZ
National Provider Identifier
1952893547
Registry record updated Feb 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
256596 Issued in AZ
Practice address
2720 W Baseline Rd # 140
Tempe, AZ 85283-1065
Phone
(602) 777-6000
NPI assigned
May 31, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 135989 IA
Family Nurse Practitioner 363LF0000X A135989 IA
Family Nurse Practitioner 363LF0000X 256596 AZ Primary

Addresses

Primary practice location

2720 W Baseline Rd # 140
Tempe, AZ 85283-1065

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210804003745 AZ Practitioner - Nurse Practitioner 2567719958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1776 W Lakes Pkwy
Suite 400
West Des Moines, IA 50266-8393

1831 E Apache Blvd Apt
Suite 1106
Tempe, AZ 85281-6668

7261 Mercy Rd
Omaha, NE 68124-2311

825 S 169TH St
Omaha, NE 68118-9300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
135989IAMDRegistered Nurse
256596AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group Arizona LLC CurrentSince Aug 1, 2021 Accepting new patients
Honorhealth-Fastmed Ambulatory Holdings LLC Past Accepting new patients

Locations

5620 W Thunderbird Rd
Ste B2
Glendale, AZ 85306
Phone (602) 547-9405

14541 W Indian School Rd
#600
Goodyear, AZ 85395
Phone (623) 535-5599

746 W University Dr
Mesa, AZ 85201
Phone (480) 668-6350

1616 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 263-8307

1618 E Thomas Rd
Phoenix, AZ 85016

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677283200000",
    "number": "1952893547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 W BASELINE RD # 140",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831065",
            "telephone_number": "602-777-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JOSHUA",
        "middle_name": "RYAN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-31",
        "last_updated": "2023-02-25",
        "certification_date": "2023-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IA",
            "license": "135989",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A135989",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "256596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.