DR. KRISTY PETERSEN (NPI# 1225127798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225127798 |
| Entity Type | Individual |
| Full Name | DR. KRISTY PETERSEN |
| Credential | MD |
| Practice Address |
3517 W Owen K Garriott Rd Suite Four Enid OK 73703-4952 |
| Mailing Address |
Po Box 3494 Enid OK 73702-3494 |
| Practice Telephone | 5802335553 |
| Mailing Telephone | 5802335553 |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2009-08-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 19458 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100253950A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407948060 | Kristy Lynn Petersen | Dentist | 10150 City Walk Dr Apt C, Woodbury, MN 55129-9270 | 2006-09-29 |
| 1003313115 | Kristy L Petersen | Nurse Practitioner | 540 The Rialto, Venice, FL 34285-2900 | 2018-04-06 |
| Street Address |
3517 W OWEN K GARRIOTT RD SUITE FOUR |
| City | ENID |
| State | OK |
| Zip Code | 73703-4952 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730127838 | Enid Clinic Inc | Pediatrics | 3517 W Owen K Garriott Rd, Suite Four, Enid, OK 73703-4952 | 2006-06-02 |
| 1508207242 | St. Mary's Laboratory, LLC | Clinical Medical Laboratory | 3517 W Owen K Garriott Rd, Suite 5, Enid, OK 73703-4952 | 2013-07-10 |
| 1093804486 | Garrett Shelton | Family Medicine | 3517 W Owen K Garriott Rd, Suite Four, Enid, OK 73703-4952 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851902233 | Gena M Ford | Massage Therapist | 2117 W Owen K Garriot, Inside Beyond Beauty, Enid, OK 73703 | 2020-08-11 |
| 1396270351 | Zoom Diagnostic Imaging LLC | Clinic/Center | 1113 West Cherry Ave, Enid, OK 73703 | 2017-04-27 |
| 1083154173 | Amanda Percival, Pllc | Counselor | 1420 W Owen K. Garriott Bldg 1, Enid, OK 73703 | 2017-03-08 |
| 1972934297 | Ty Stroble | Behavioral Analyst | 408 N Oakwood, Apt.13d, Enid, OK 73703 | 2013-12-12 |
| 1801132204 | Ryan Patrick Williams | Dentist | 2510 W Chestnut Ave, Ste A, Enid, OK 73703 | 2012-12-13 |
| 1295094720 | Heather Jeanette Linder | Counselor | 2700 N. Vanburen, Trailer 240, Enid, OK 73703 | 2012-05-03 |
| 1366729477 | Karen Lynn Harris | Counselor | 1625 W. Garriot, Suite F, Enid, OK 73703 | 2011-11-03 |
| 1659666501 | Courtney Michelle Pike | Behavioral Analyst | 1625 West Owen K Garriott Road # F, Enid, OK 73703 | 2011-06-17 |
| 1194040089 | Erin K. Roberts, Dds, Plc | Dentist | 1402 N Van Buren, Enid, OK 73703 | 2010-04-02 |
| 1770812109 | Tabitha Janel Simon | Counselor | 529 North Grand, Enid, OK 73703 | 2009-12-14 |
| Find all providers in zip 73703 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952627069 | Jon Randall Mills Jr. | Family Medicine | 620 S Madison St Ste 203, Enid, OK 73701-7270 | 2010-04-14 |
| 1376746925 | Dustin Lee Baylor | Family Medicine | 2821 N Van Buren, Suite B, Enid, OK 73701-7273 | 2007-06-08 |
| 1639224264 | Jami Luann Benton | Family Medicine | 915 E Garriott Rd Ste B, Enid, OK 73701-6153 | 2007-01-24 |
| 1013006394 | David Matousek | Family Medicine | 330 S 5th St Ste 302, Enid, OK 73701-5862 | 2006-10-12 |
| 1609965136 | Richard Rivers | Family Medicine | 3517 W Owen K Garriott Rd Ste 4, Enid, OK 73703-4953 | 2006-10-12 |
| 1659394765 | Dwayne Lee Janzen | Family Medicine | 915 E Garriott Rd Ste A, Enid, OK 73701-6153 | 2006-07-26 |
| 1144261546 | Seth H. Switzer | Family Medicine | 302 N Independence St Ste 700, Enid, OK 73701-4046 | 2006-06-09 |
| 1043200793 | David Barnard | Family Medicine | 527 Gott Rd, Enid, OK 73705-5103 | 2005-10-25 |
| 1295735355 | Jeffrey R Jones | Family Medicine | 2821 N Van Buren St Ste B, Enid, OK 73703-1729 | 2005-07-29 |
| 1144830506 | Primed Healthcare LLC | Family Medicine | 822 W Randolph Ave, Enid, OK 73701-3834 | 2020-07-31 |
| Find all providers in ENID | ||||
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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.