MARK ALAN PETERSON (NPI# 1164069696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164069696 |
| Entity Type | Individual |
| Full Name | MARK ALAN PETERSON |
| Credential | EDS |
| Practice Address |
5870 Nw 54th Ct Johnston IA 50131-1418 |
| Practice Telephone | 5154624367 |
| Mailing Telephone | 5154624367 |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2019-12-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 253Z00000X | In Home Supportive Care | IA | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841474012 | Mark Frederic Peterson I | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3351 36th St, Grand Rapids, MI 49331 | 2007-12-24 |
| 1780877258 | Mark A. Peterson | Counselor | 7322 Scenic Oaks Cir, Austin, TX 78745-5217 | 2007-08-19 |
| 1871702076 | Mark Clayton Peterson | Dentist | 1600 W Sunset Rd Ste B, Henderson, NV 89014-2655 | 2007-05-22 |
| 1558481366 | Mark Theodore Peterson | Specialist | 5712 Newburg Rd, Rockford, IL 61108-6707 | 2007-03-29 |
| 1073608170 | Mark A Peterson | Dentist | 7740 Bay St, Suite # 1, Sebastian, FL 32958-3427 | 2006-10-04 |
| 1689782864 | Mark L Peterson | Dentist | 127 1/2 E Short St, Rigby, ID 83442-1422 | 2006-08-28 |
| 1528013661 | Mark Edward Peterson | Dentist | 2440 Gaynor Nw, Grand Rapids, MI 49544-1830 | 2006-05-24 |
| 1699763607 | Mark Delano Peterson | Orthopaedic Surgery | 1311 E Barnett Rd, Ste 201, Medford, OR 97504-8225 | 2005-10-12 |
| 1477551836 | Mark Dean Peterson | Chiropractor | 5406 Alderson St, Schofield, WI 54476-2264 | 2005-07-11 |
| 1477043842 | Mark Peterson | Student in an Organized Health Care Education/Training Program | 1115 20th St Ste 205, Huntington, WV 25703-2071 | 2018-05-11 |
| Street Address |
5870 NW 54TH CT |
| City | JOHNSTON |
| State | IA |
| Zip Code | 50131-1418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568011229 | Joseph Barnard | Technician | 6406 Theresa Dr, Johnston, IA 50131 | 2019-09-05 |
| 1073098208 | Heather Nicole Prettyman | Social Worker | 5406 Marle Hay Rd., Johnston, IA 50131 | 2018-10-03 |
| 1982182606 | Dental Studio of Iowa PC | Dentist | 5495 Nw 100th Street, Johnston, IA 50131 | 2018-08-03 |
| 1982063921 | Braincare, LLC | Physiological Laboratory | 6165 Nw 86th St Ste 130, Johnston, IA 50131 | 2016-02-18 |
| 1104293570 | Sarah Michelle Fees | Nurse Practitioner | 8605 Chambery Blvd, Johnston, IA 50131 | 2015-09-01 |
| 1013329978 | Jonathan Jeffrey Karch | Dentist | 5495 Nw 100th St, Johnston, IA 50131 | 2014-05-27 |
| 1053757500 | Patricia L Hart | Social Worker | 6061 Bradford Ln, Johnston, IA 50131 | 2013-05-10 |
| 1205105855 | Lesile Jane Mentele | Pharmacist | 6100 Nw 97th St, Johnston, IA 50131 | 2011-12-27 |
| 1750610812 | Amanda J Moore | Chiropractor | 8671 Northpark Ct, Johnston, IA 50131 | 2009-12-18 |
| 1225293426 | Center for Maximized Living, LLC | Chiropractor | 8671 Northpark Ct., Johnston, IA 50131 | 2008-07-28 |
| Find all providers in zip 50131 | ||||
| Taxonomy Code | 253Z00000X |
| Grouping | Agencies |
| Classification | In Home Supportive Care |
| An In Home Supportive Care Agency provides services in the patient’s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043546088 | Tri-town Economic Opportunity Committee | In Home Supportive Care | 1126 Hartford Ave, Johnston, RI 02919-7109 | 2009-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493895 | Roseman Home Care Iowa, Inc. | In Home Supportive Care | 650 Scott Park Dr, Iowa City, IA 52245-5140 | 2020-10-03 |
| 1568076164 | Guardian Homecare Agency | In Home Supportive Care | 1040 90th St, West Des Moines, IA 50266-3306 | 2020-09-02 |
| 1043834914 | Vibrant Scl, LLC | In Home Supportive Care | 1776 22nd St Ste 201, West Des Moines, IA 50266-1444 | 2020-06-05 |
| 1114548757 | My Nurse Healthcare, LLC | In Home Supportive Care | 124 Huron Cir, Council Bluffs, IA 51501-8327 | 2020-05-06 |
| 1437785730 | Bersol Open Home Care LLC | In Home Supportive Care | 416 Drake St Sw, Cedar Rapids, IA 52404-8216 | 2020-03-18 |
| 1366072670 | Zion Home Care LLC | In Home Supportive Care | 906 E Madison Ave, Des Moines, IA 50313-3727 | 2020-01-26 |
| 1720625478 | Loving House of Hearts | In Home Supportive Care | 1129 Winchester Lane, North Liberty, IA 52317 | 2019-12-02 |
| 1992348585 | Alpha Home Care Solutions Inc | In Home Supportive Care | 2901 Douglas Ave Ste 2c, Des Moines, IA 50310-5856 | 2019-10-25 |
| 1235789488 | Theodore Timothy Franks | In Home Supportive Care | 136 32nd St Ne, Cedar Rapids, IA 52402-6008 | 2019-09-18 |
| 1093362923 | Phil Schomer | In Home Supportive Care | 1497 Nw 66th Ave, Des Moines, IA 50313-5427 | 2019-08-26 |
| Find all providers with the same taxonomy | ||||
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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.