MICHAEL PETERSON (NPI# 1144885575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144885575 |
| Entity Type | Individual |
| Full Name | MICHAEL PETERSON |
| Credential | PA-C |
| Practice Address |
2801 Nw Mercy Dr Ste 300 Roseburg OR 97471-2348 |
| Mailing Address |
201 Nw Medical Loop Ste 190 Roseburg OR 97471-8835 |
| Practice Telephone | 5416771555 |
| Practice Fax Number | 5416772294 |
| Mailing Telephone | 5416774319 |
| Mailing Fax Number | 5416772294 |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2020-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA197860 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942794839 | Michael Peterson | Physician Assistant | 3181 Sw Sam Jackson Park Rd # P31, Portland, OR 97239-3098 | 2018-06-14 |
| 1548715634 | Michael Latrae Peterson | Social Worker | 6767 W Windmill Ln, Las Vegas, NV 89139-6501 | 2016-08-18 |
| 1033544119 | Michael Robert Peterson | Counselor | 522 4th St S, Stillwater, MN 55082-4966 | 2013-09-09 |
| 1750651113 | Michael Peterson | Social Worker | 1400 N Hayworth Ave Apt 9, West Hollywood, CA 90046-3836 | 2012-01-03 |
| 1578848131 | Michael Dean Peterson | Dentist | 4710 Amber Valley Pkwy S, Ste A, Fargo, ND 58104 | 2011-10-14 |
| 1467693119 | Michael Lamont Peterson | Registered Nurse | 13 Hollister St, Rochester, NY 14605-1401 | 2009-03-10 |
| 1003062001 | Michael Carl Peterson | Physical Therapist | 2850 Mitchell Rd, Jamestown, NY 14701-8906 | 2008-08-11 |
| 1942472691 | Michael E Peterson | Dentist | 5355 W State St, Boise, ID 83703-3333 | 2008-04-01 |
| 1134325145 | Michael W Peterson | Dentist | 1319 Tennessee St, Vallejo, CA 94590 | 2007-06-26 |
| 1609079094 | Michael Gene Peterson | Emergency Medicine | 201 E. Nicollet Blvd., Burnsville, MN 55337 | 2007-06-06 |
| Street Address |
2801 NW MERCY DR STE 300 |
| City | ROSEBURG |
| State | OR |
| Zip Code | 97471-2348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841294774 | Douglas Edward Anderson | Internal Medicine | 2801 Nw Mercy Dr Ste 300, Roseburg, OR 97471-2348 | 2005-06-09 |
| 1417225939 | Ibrahim Osman | Internal Medicine | 2801 Nw Mercy Dr Ste 300, Roseburg, OR 97471 | 2011-12-12 |
| 1932499373 | Deepika Narasimha | Internal Medicine | 2801 Nw Mercy Dr Ste 300, Roseburg, OR 97471-2348 | 2011-04-18 |
| 1265745715 | Ashraf Abusara | Internal Medicine | 2801 Nw Mercy Dr Ste 300, Roseburg, OR 97471-2348 | 2010-07-26 |
| 1033365135 | Centennial Medical Group Inc. | Internal Medicine | 2801 Nw Mercy Dr Ste 300, Roseburg, OR 97471-2348 | 2008-08-08 |
| 1720278922 | Ortho Spine LLC | Orthopaedic Surgery | 2801 Nw Mercy Dr Ste 300, Roseburg, OR 97470-2348 | 2007-07-25 |
| 1285753160 | Courtney Rae Virgilio | Internal Medicine | 2801 Nw Mercy Dr Ste 300, Roseburg, OR 97471-2348 | 2007-03-29 |
| 1639174527 | Dana M Finch | Nurse Practitioner | 2801 Nw Mercy Dr Ste 300, Roseburg, OR 97471 | 2005-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841805660 | Rae Ann Barnes | Pharmacist | 913 Ne Garden Valley Blvd, Pharmacy, Roseburg, OR 97471 | 2020-09-09 |
| 1023651031 | Colton Phillips | Behavioral Analyst | 940 Nw Garden Valley Bvld #104, Roseburg, OR 97471 | 2019-10-22 |
| 1952884876 | Meredith Krugel Lcsw PC | Clinic/Center | 2225 Nw Stewart Parkway Ste 200, Roseburg, OR 97471 | 2018-09-07 |
| 1114456563 | Philip Kaser Family, LLC | Pharmacy | 1175 W. Harvard Avenue, Roseburg, OR 97471 | 2017-06-08 |
| 1053854208 | Icco LLC | Clinic/Center | 1740 Nw Goetz Street, Roseburg, OR 97471 | 2016-11-21 |
| 1770034589 | Evie Jepsen | Case Manager/Care Coordinator | 2700 Stewart Parkway Annex B, Suite 110, Roseburg, OR 97471 | 2016-10-17 |
| 1932551256 | Jonathan Schmidt | Licensed Practical Nurse | 913 Nm Garden Valley Blvd, Va Roseburg Medical Center, Roseburg, OR 97471 | 2016-07-11 |
| 1932580586 | Jeffrey Mark Wareham | Case Manager/Care Coordinator | 2700 Medical Loop, Annex B, Roseburg, OR 97471 | 2015-06-09 |
| 1558784215 | Ginger Jean Thibedeau | Massage Therapist | 3019 Nw Stewart Parkway, Suite 304 #183, Roseburg, OR 97471 | 2014-01-30 |
| 1427303122 | Karishma Parekh | Internal Medicine | 2460 Nw Stewart Pkwy Ste 103, Roseburg, OR 97471 | 2012-07-18 |
| Find all providers in zip 97471 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902412505 | Lisa Mai | Physician Assistant | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1214 | 2020-09-18 |
| 1609480359 | Jacob Watters | Physician Assistant | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2020-09-01 |
| 1851937924 | Thanita Pradhanang | Physician Assistant | 1740 Nw Goetz St, Roseburg, OR 97471-1613 | 2019-11-22 |
| 1679129753 | Shannon Danette Trammell | Physician Assistant | 340 Nw Medical Loop, Roseburg, OR 97471-1645 | 2019-08-14 |
| 1962978866 | Kaitlyn E Bogardus | Physician Assistant | 2570 Nw Edenbower Blvd Ste 100, Roseburg, OR 97471-6214 | 2018-10-17 |
| 1740761519 | Alex Renee Shaffer | Physician Assistant | 150 Ne Kenneth Ford Dr, Roseburg, OR 97470-1042 | 2018-08-28 |
| 1629554811 | Gary Sorcher | Physician Assistant | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2018-07-11 |
| 1548756158 | Timothy Lawrence Garvey Jr. | Physician Assistant | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2018-07-06 |
| 1437641404 | Michael F Graham | Physician Assistant | 2570 Nw Edenbower Blvd., Suite 100, Roseburg, OR 97471-6214 | 2018-06-05 |
| 1801314372 | Jacob Dean Thompson | Physician Assistant | 1813 W Harvard Ave, #310, Roseburg, OR 97471 | 2017-09-06 |
| Find all providers in ROSEBURG | ||||
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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.