Susan Wynn Peterson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

200101115 Issued in NC

Practice address

711 New Leicester Hwy
Asheville, NC 28806-1048

Phone

(828) 253-3717

Fax

(828) 252-8072

NPI assigned

Dec 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC, TX2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Choctaw Nation of Oklahoma

  • Rural Acute Care Hospital
  • Talihina, OK
  • NPI 1659347623

  TX

  Medicare reassignment NPD
• Appalachian Mountain Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Robbinsville, NC
  • NPI 1780064832
  Medicare reassignment
• Choctaw Nation of Oklahoma

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Broken Bow, OK
  • NPI 1447143532
  NPD
• Choctaw Nation of Oklahoma

  • Primary Care Clinic/Center
  • Talihina, OK
  • NPI 1982992269
  NPD
• Appalachian Mountain Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Asheville, NC
  • NPI 1336528314
  NPD (past)
• Parkway Family Physicians PA

  • Family Medicine Physician
  • Asheville, NC
  • NPI 1730206301
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1992869721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2063",
            "address_2": "SUITE A",
            "city": "LEICESTER",
            "state": "NC",
            "postal_code": "287482063",
            "telephone_number": "828-622-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 NEW LEICESTER HWY",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288061048",
            "telephone_number": "828-253-3717",
            "fax_number": "828-252-8072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "304 New Leicester Hwy",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "28806",
            "country_code": "US",
            "telephone_number": "828-255-4723",
            "fax_number": "828-255-4726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SUSAN",
        "middle_name": "WYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200101115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89129H0",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00072623",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaime Lynne Peterson, DDS
• Maegan Cambron Peterson, AGACNP-BC
• Megan Alissa Peterson, PA-C
• Misty N Peterson, M.A., LPC
• Neil P Peterson, MD
• Susan Pethel, MPT
• Andrea G Petrone, FNP
• Julia Felicia Petteway, MS, CNM, WHNP-BC
• David Charles Pettigrew, M.D.
• Sarah Christine Pettinelli

• Family Medicine Physician in Asheville, NC
• Providers in Asheville, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.