Active NPI
Joshua Ryan Peterson, ARNP
- Family Nurse Practitioner
- Tempe, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 256596
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| 135989 | IA | MD | Registered Nurse |
| 256596 | AZ | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Group Arizona LLC | Current | 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.
-
- Family Medicine Physician
- Glendale, AZ
- NPI 1053810622
-
dba HonorHealth FastMed Urgent Care
- Urgent Care Clinic/Center
- Surprise, AZ
- NPI 1467069047
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.