DR. ANDREW ALBERT PETERSON (NPI# 1083842033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083842033 |
| Entity Type | Individual |
| Full Name | DR. ANDREW ALBERT PETERSON |
| Credential | M.D. |
| Practice Address |
190 E Bannock St Boise ID 83712-6241 |
| Practice Telephone | 2083812094 |
| Practice Fax Number | 2083811791 |
| Mailing Telephone | 2083812094 |
| Mailing Fax Number | 2083811791 |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2016-07-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
M-13255 | ID | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447723044 | Andrew J Peterson | Podiatrist | 1609 Quail Dr, Sarasota, FL 34231-3538 | 2019-01-07 |
| 1720559016 | Andrew Frederick Peterson | Dentist | 1670 Beam Ave Ste 202, Maplewood, MN 55109-1225 | 2018-12-11 |
| 1619318755 | Andrew Gregory Peterson | Dentist | 15962 Boones Ferry Rd Ste 108, Lake Oswego, OR 97035-4359 | 2013-07-16 |
| 1326184953 | Andrew A Peterson | Dentist | 215 Justice St, Fremont, OH 43420-2420 | 2007-01-30 |
| 1477601698 | Andrew M Peterson | Pharmacist | 508 Garwood Dr, Cherry Hill, NJ 08003-3406 | 2007-01-05 |
| 1144337338 | Andrew Eric Peterson | Chiropractor | 1251 Shell Beach Rd, Pismo Beach, CA 93449 | 2006-08-24 |
| 1306826854 | Andrew J. Peterson | Internal Medicine | 147 Reynoir Street, Suite 101, Biloxi, MS 39530 | 2006-01-20 |
| 1649877069 | Andrew Peterson | Massage Therapist | 2902 164th St Sw Ste D1, Lynnwood, WA 98087-3201 | 2020-10-08 |
| 1255995536 | Andrew Curtis Peterson | Student in an Organized Health Care Education/Training Program | 701 Park Ave, Minneapolis, MN 55415-1623 | 2019-04-23 |
| 1679028534 | Andrew Peterson | Physical Therapist | 360 Dardanelli Ln, Suite 1f, Los Gatos, CA 95032-1421 | 2016-08-22 |
| Street Address |
190 E BANNOCK ST |
| City | BOISE |
| State | ID |
| Zip Code | 83712-6241 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770586794 | St Lukes Regional Medical Center | Pharmacy | 190 E Bannock St, Boise, ID 83712-6241 | 2005-05-23 |
| 1275133944 | St Lukes Health System Ltd | General Acute Care Hospital | 190 E Bannock St, Boise, ID 83712-6241 | 2020-10-30 |
| 1750980017 | Andrea Johnson Murray | Pharmacy Technician | 190 E Bannock St, Boise, ID 83712-6241 | 2020-10-19 |
| 1679180103 | Katie Marie Pond | Social Worker | 190 E Bannock St, Boise, ID 83712-6241 | 2020-09-29 |
| 1780297762 | Alexandria Marie Schultz | Pharmacist | 190 E Bannock St, Boise, ID 83712-6241 | 2020-08-28 |
| 1225640048 | Tania Michelle Villanueva-sanchez | Pharmacist | 190 E Bannock St, Boise, ID 83712-6241 | 2020-08-21 |
| 1154931426 | Brittany Nichole Galop | Pharmacist | 190 E Bannock St, Boise, ID 83712-6241 | 2020-08-03 |
| 1558970046 | Emily Michelle Bush | Pharmacist | 190 E Bannock St, Boise, ID 83712-6241 | 2020-07-30 |
| 1699393447 | Chadd Miller Ramos | Pharmacist | 190 E Bannock St, Boise, ID 83712-6241 | 2020-07-08 |
| 1740819127 | Lindzee Searle | Pharmacy Technician | 190 E Bannock St, Boise, ID 83712-6241 | 2020-04-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477016012 | Veranda At Barber Station LLC | Assisted Living Facility | 3266 E. Barber Valley Drive, Boise, ID 83712 | 2019-04-10 |
| 1891258612 | Mary Elizabeth Riedel | Occupational Therapist | 190 E Bancock St., Boise, ID 83712 | 2019-04-09 |
| 1427523968 | Q17 Health Partners LLC | Surgery | 100 East Idaho Street #317, Boise, ID 83712 | 2018-10-11 |
| 1053898247 | Travis Dale Worwood | Social Worker | South Entrance, 1075 E. Park Blvd, Boise, ID 83712 | 2018-07-20 |
| 1689166761 | Kristen Nicole Ray | Social Worker | 109 E Bannock St, Boise, ID 83712 | 2018-06-04 |
| 1740706894 | Meghan Heitstuman | Social Worker | 190 E Bannock Street, Boise, ID 83712 | 2017-08-21 |
| 1942759725 | Kay Craig | Physical Therapist | 190 Bannock, Boise, ID 83712 | 2016-09-22 |
| 1235686395 | Sharon Bjornson | Physical Therapist | 190 East Bannack, Boise, ID 83712 | 2016-09-07 |
| 1033576491 | Heather Hussey | Genetic Counselor, MS | 100 E Idaho Street, Msti Genetics, Boise, ID 83712 | 2016-01-15 |
| 1295139137 | Amie Bartholomeus | Massage Therapist | 100 East Idaho Street, St Luke's Mountain States Tumor Institute, Boise, ID 83712 | 2014-10-21 |
| Find all providers in zip 83712 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154584712 | Gem State Radiology LLP | Radiology | 161 E Mallard Dr, Suite 130, Boise, ID 83706-3974 | 2008-07-03 |
| 1760682066 | Paul David Sonntag | Radiology | 190 E Bannock, Boise, ID 83712 | 2007-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508224379 | Teton Vascular Institute of Pocatello A Series of Teton Group | Radiology | 444 Hospital Way Bldg 100, Ste 111, Pocatello, ID 83201-2745 | 2016-02-08 |
| 1851871172 | Russell L Evans | Radiology | 320 Warner Dr, Lewiston, ID 83501-4441 | 2018-08-16 |
| 1629007844 | Idaho Vascular Institute Pllc | Radiology | 4400 E Flamingo Ave, Nampa, ID 83687-9203 | 2006-07-01 |
| 1386685535 | David Shelley | Radiology | 98 Poplar St, Blackfoot, ID 83221-1758 | 2006-06-09 |
| 1316913254 | John H Whiting Jr. | Radiology | 444 Hospital Way, Suite 701, Pocatello, ID 83201-2701 | 2006-02-28 |
| 1356329783 | David Reed Condie | Radiology | 98 Poplar St, Blackfoot, ID 83221-1758 | 2006-01-05 |
| 1023096955 | John W. Ho | Radiology | 415 6th St, Lewiston, ID 83501-2431 | 2005-12-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.