John Petersen, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

Q0536 Issued in TX

Practice address

4705 Briarwood Avenue
Midland, TX 79707-2639

Phone

(432) 505-4145

Fax

(833) 941-0864

NPI assigned

May 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: john.petersen.1@26958.direct.athenahealth.com

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.

• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019
  Medicare reassignment NPD
• Midland Emergency Managers PLLC

  • Emergency Medicine Physician
  • Midland, TX
  • NPI 1720673122
  Medicare reassignment NPD
• Wes Tex Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Odessa, TX
  • NPI 1588043707

  Emergency Medicine

  Medicare reassignment NPD
• Urgent Care Providers PLLC

  • Urgent Care Clinic/Center
  • Midland, TX
  • NPI 1457131294
  Medicare reassignment
• Wes Tex Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • Midland, TX
  • NPI 1225723125
  NPD
• Wes Tex Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • Midland, TX
  • NPI 1912421645
  NPD
• Wes Tex Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • Andrews, TX
  • NPI 1942084322
  NPD (past)
• James I Stubblefield, MD Inc a Professional Medical Corporation

  • Emergency Medicine Physician
  • Salinas, CA
  • NPI 1669561247
  NPD (past)
• Santa Cruz Emergency Physicians Medical Group

  • Emergency Medicine Physician
  • Santa Cruz, CA
  • NPI 1396761722
  NPD (past)

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1972506442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 BRIARWOOD AVENUE",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797072639",
            "telephone_number": "432-505-4145",
            "fax_number": "833-941-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 BRIARWOOD AVENUE",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797072639",
            "telephone_number": "432-505-4145",
            "fax_number": "833-941-0864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6950 Eastridge Road",
            "address_purpose": "LOCATION",
            "city": "Odessa",
            "state": "TX",
            "postal_code": "797658971",
            "country_code": "US",
            "telephone_number": "432-505-4145",
            "fax_number": "833-941-0862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G74917",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q0536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Permian Nephrology Associates, PA
• Permian Occupational Medicine
• Allyese Perry, PA-S
• Joan Sybell Petalcorin, M.D.
• Ginger Michelle Peters, PA
• Ginger Lea Peugh, AU.D.
• Angie Pham, PA-S
• Hung Doan Pham, PHARM. D
• Thinh Phu Phan, MD
• Tracy Ann Phan

• Internal Medicine Physician in Midland, TX
• Providers in Midland, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.