DR. BRIAN R PETERSON (NPI# 1316978687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316978687 |
| Entity Type | Individual |
| Full Name | DR. BRIAN R PETERSON |
| Credential | M.D. |
| Practice Address |
3584 W 9000 S Suite 311 West Jordan UT 84088-5710 |
| Practice Telephone | 8015668304 |
| Practice Fax Number | 8015668304 |
| Mailing Telephone | 8015668304 |
| Mailing Fax Number | 8015668304 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2020-11-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Y00000X | Otolaryngology | 036142390 | IL | Allopathic & Osteopathic Physicians |
| Y | 207YX0901X |
Otolaryngology Specialization: Otology & Neurotology |
313974-1205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE GROUP PTAN | 214881 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2601 W Main St, Carbondale, IL 629011031 | 6185495361 | 6183514878 |
| 2601 W Main St, Carbondale, IL 629011031 | 6183517300 | 6184577890 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194984070 | Brian Carl Peterson | Physical Therapy Assistant | 10439 64th Ln Ne, Albertville, MN 55301-3533 | 2008-06-05 |
| 1437328267 | Brian Christopher Peterson | Case Manager/Care Coordinator | 2485 Roosevelt Blvd, Eugene, OR 97402-2562 | 2008-02-26 |
| 1316158777 | Brian Eugene Peterson | Physical Therapy Assistant | 12139 S. Williams St, Dunellon, FL 34431 | 2007-05-25 |
| 1427174515 | Brian Peterson | Physical Therapist | 907 E Briggs Ave, Fairfield, IA 52556-3007 | 2007-03-21 |
| 1225119621 | Brian Jared Peterson | Emergency Medicine | 1730 Alpine Blvd Ste 109b, Alpine, CA 91901-3877 | 2006-10-18 |
| 1306865027 | Brian K Peterson | Physical Therapist | 41 E. 1140 N. Suite A, Saratoga Springs, UT 84045 | 2006-07-19 |
| 1962434951 | Brian Lee Peterson | Pathology | 933 W Highland Ave, Milwaukee, WI 53233-1445 | 2006-07-07 |
| 1275093676 | Brian Peterson | Student in an Organized Health Care Education/Training Program | 1215 Lee St, Charlottesville, VA 22908-0816 | 2019-03-21 |
| 1023401882 | Brian Peterson | Registered Nurse | 400 N Pepper Ave, Colton, CA 92324-1801 | 2015-03-17 |
| 1144655937 | Brian L Peterson | Physical Therapist | 107 E Highland Dr, Oconto Falls, WI 54154-1002 | 2013-09-11 |
| Street Address |
3584 W 9000 S SUITE 311 |
| City | WEST JORDAN |
| State | UT |
| Zip Code | 84088-5710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407854821 | Harrison M Lazarus | Surgery | 3584 W 9000 S, Ste 400, West Jordan, UT 84088-5710 | 2005-07-09 |
| 1912494345 | Nathan L. Boyer | Nurse Practitioner | 3584 W 9000 S, West Jordan, UT 84088-5710 | 2018-04-20 |
| 1194262022 | Matthew Allred | Nurse Practitioner | 3584 W 9000 S, Suite 405, West Jordan, UT 84088-5710 | 2017-01-30 |
| 1366803736 | Bryce Dee Allred Md A PC | Clinic/Center | 3584 W 9000 S, Suite 400, West Jordan, UT 84088-5710 | 2016-03-14 |
| 1689042673 | Ariel Lynn Fry | Dietitian, Registered | 3584 W 9000 S, Suite 304, West Jordan, UT 84088-5710 | 2015-09-08 |
| 1598146888 | Larsen Anesthesia PC | Anesthesiology | 3584 W 9000 S, West Jordan, UT 84088-5710 | 2015-06-12 |
| 1649662560 | Ryan Fowers | Specialist/Technologist | 3584 W 9000 S, West Jordan, UT 84088-5710 | 2015-03-02 |
| 1255746350 | Le Pediatrics Inc | Clinic/Center | 3584 W 9000 S, Suite 305, West Jordan, UT 84088-5710 | 2014-06-26 |
| 1609292044 | Weekend Vasectomy Clinic LLC | Specialist | 3584 W 9000 S, Suite 401, West Jordan, UT 84088-5710 | 2014-03-10 |
| 1902239478 | Adam Alex Nelson | Physician Assistant | 3584 W 9000 S, Suite 311, West Jordan, UT 84088-5710 | 2013-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881178655 | Sierra Burt | Physician Assistant | 3584 West 90000 South Suite 304, West Jordan, UT 84088 | 2018-09-18 |
| 1659861847 | Miller Anesthesia Consultants PC | Anesthesiology | Jvmc Dept. of Anesthesiology, 3580 W. 9000 S., West Jordan, UT 84088 | 2018-05-14 |
| 1821501495 | Cleo Stephanides Cheney | Dentist | 8846 South Redwood Rd., Suite N201, West Jordan, UT 84088 | 2017-11-06 |
| 1124546742 | Crystal Lynn Santos | Counselor | 4431 8200 S, West Jordan, UT 84088 | 2017-09-04 |
| 1154705960 | Heston Farnsworth | Dentist | 9217 South Redwood Road, Suite B, West Jordan, UT 84088 | 2015-07-13 |
| 1750778767 | Andrew Cantwell | Dentist | 3855 7800 South #150, West Jordan, UT 84088 | 2015-04-17 |
| 1962764282 | Steven Howard Reano | Specialist | 8789 S Redwood Road, Ste 100, West Jordan, UT 84088 | 2012-06-12 |
| 1528328846 | Orthodontic Payment Services, LLC | Dentist | 1231 W 9000 S #d, West Jordan, UT 84088 | 2012-05-21 |
| 1588932321 | Jessica Millard | Counselor | 9278 S 1700 W, West Jordan, UT 84088 | 2011-12-08 |
| 1346553062 | Barbara Rouse | Counselor | 9278 Redwood Rd, West Jordan, UT 84088 | 2010-07-22 |
| Find all providers in zip 84088 | ||||
| Taxonomy Code | 207YX0901X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otology & Neurotology |
| An otolaryngologist who treats diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology and neurotology emphasizes the study of embryology, anatomy, physiology, epidemiology, pathophysiology, pathology, genetics, immunology, microbiology and the etiology of diseases of the ear and temporal bone. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528095627 | William I Owens II | Otolaryngology | 1100 Country Hills Dr, #200, Ogden, UT 84403-2503 | 2006-06-26 |
| 1811151558 | David Spencer Darley | Otolaryngology | 1055 N 300 W, Suite 401, Provo, UT 84604-3344 | 2008-07-11 |
| 1710196290 | Richard K Gurgel | Otolaryngology | 50 N Medical Dr, Som 3c120, Salt Lake City, UT 84132-0001 | 2007-05-22 |
| 1316153695 | Eric Lee Slattery | Otolaryngology | 22 S 900 E, Salt Lake City, UT 84102-1307 | 2007-05-15 |
| 1891885414 | Clough Shelton | Otolaryngology | 100 N Medical Dr, Salt Lake City, UT 84113-1103 | 2006-10-13 |
| City | WEST JORDAN |
| Zip Code | 84088 |
Please comment or provide details below to improve the information on DR. BRIAN R PETERSON.
| 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.