Michael Peterson, AA

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

License

000749 Issued in GA

Practice address

5665 Peachtree Dunwoody Rd NE
Atlanta, GA 30342-1701

Phone

(404) 851-7324

Fax

(404) 843-2627

NPI assigned

Jan 9, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

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

Associate of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northside Anesthesiology Consultants, LLC

  • Anesthesiology Physician
  • Atlanta, GA
  • NPI 1083600308
  NPD (past)
• Peachtree Orthopaedic Surgery Center-North, LLC

  • Ambulatory Surgical Clinic/Center
  • Cumming, GA
  • NPI 1093389421
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1982753109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5671 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 530",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303425000",
            "telephone_number": "404-257-1415",
            "fax_number": "404-851-1649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5665 PEACHTREE DUNWOODY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421701",
            "telephone_number": "404-851-7324",
            "fax_number": "404-843-2627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MICHAEL",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "000749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Marie Peterson, PHD
• Kristen Peterson, LAT, ATC
• Kristofor Mikael Peterson, DC
• Leigh Ann Peterson, LPC, CEAP, SAP
• Mary Peterson, CRNA
• Quendall Peterson, RPH
• Ryan Brent Peterson, M.D.
• Sara Alice Peterson, LPC
• Stephanie Peterson, PA-C
• Susan C. Peterson, PA-AA

• Anesthesiologist Assistant in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Anesthesiologist Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.