Active NPI
Perry Herman Peterson, D.P.M.
- Podiatrist
- Marble Falls, TX
National Provider Identifier
1982715439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 0567
- Practice address
- 325 County Road 144B
Marble Falls, TX 78654-8020 - Phone
- (830) 798-8314
- NPI assigned
- Aug 31, 2006
- Last updated
- Nov 30, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 0567 | TX | Primary |
| Public Medicine Podiatrist | 213EP0504X | 0567 | TX | |
| Primary Podiatric Medicine Podiatrist | 213EP1101X | 0567 | TX | |
| Sports Medicine Podiatrist | 213ES0000X | 0567 | TX | |
| Foot Surgery Podiatrist | 213ES0131X | 0567 | TX |
Addresses
Primary practice location
325 County Road 144B
Marble Falls, TX 78654-8020
Mailing address
325 County Road 144B
Marble Falls, TX 78654-8020
Phone (830) 798-8314
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00AM35 | Other | TX | BLUE CROSS BLUE SHIELD |
| 0008138-01 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0567 | TX | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417305600000",
"number": "1982715439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 COUNTY ROAD 144B",
"city": "MARBLE FALLS",
"state": "TX",
"postal_code": "786548020",
"telephone_number": "830-798-8314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 COUNTY ROAD 144B",
"city": "MARBLE FALLS",
"state": "TX",
"postal_code": "786548020",
"telephone_number": "830-798-8314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "PERRY",
"middle_name": "HERMAN",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2014-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "TX",
"license": "0567",
"primary": true
},
{
"code": "213EP0504X",
"taxonomy_group": "",
"desc": "Podiatrist, Public Medicine",
"state": "TX",
"license": "0567",
"primary": false
},
{
"code": "213EP1101X",
"taxonomy_group": "",
"desc": "Podiatrist, Primary Podiatric Medicine",
"state": "TX",
"license": "0567",
"primary": false
},
{
"code": "213ES0000X",
"taxonomy_group": "",
"desc": "Podiatrist, Sports Medicine",
"state": "TX",
"license": "0567",
"primary": false
},
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "TX",
"license": "0567",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00AM35",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0008138-01",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marble Falls, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.