DR. MARK WILLIAM PETERSON (NPI# 1326374562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1326374562 |
Entity Type | Individual |
Full Name | DR. MARK WILLIAM PETERSON |
Credential | DO |
Practice Address |
2200 Park Ave. Bldg. D Ste. 100 Park City UT 84060 |
Mailing Address |
101 Sun Meadow Dr Centerton AR 72719-9610 |
Practice Telephone | 4356158822 |
Practice Fax Number | 4356158823 |
Mailing Telephone | 4797950426 |
Enumeration Date | 2009-10-22 |
Last Update Date | 2020-02-18 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207Q00000X | Family Medicine | E7679 | AR | Allopathic & Osteopathic Physicians |
N | 207Q00000X | Family Medicine | 5101018542 | MI | Allopathic & Osteopathic Physicians |
Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
8743560-1204 | UT | Allopathic & Osteopathic Physicians |
N | 390200000X | Student in an Organized Health Care Education/Training Program | 5101018542 | MI | Student, Health Care |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164069696 | Mark Alan Peterson | In Home Supportive Care | 5870 Nw 54th Ct, Johnston, IA 50131-1418 | 2019-12-03 |
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 |
Street Address |
2200 PARK AVE. BLDG. D STE. 100 |
City | PARK CITY |
State | UT |
Zip Code | 84060 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851406011 | Lindsey Elizabeth Marshall | Physician Assistant | 2200 Park Ave. Bldg. D Ste. 100, Park City, UT 84060 | 2006-08-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982233920 | Livecare, Inc. | Nursing Care | 1830 Prospector Avenue, Park City, UT 84060 | 2020-04-02 |
1063904266 | Louise Knetzger Gallagher | Acupuncturist | 1107 Woodside Ave, Park City, UT 84060 | 2018-06-04 |
1942753421 | Valerie Alison Mey | Dietitian, Registered | 2985 Arabian Dr, Park City, UT 84060 | 2016-08-01 |
1659720936 | Vibrant Health PC | Anesthesiology | 1910 Prospector Ave Suite 302, Park City, UT 84060 | 2016-06-08 |
1538538657 | Pamela Hilbert | Dentist | 1830 Prospector Ave., Park City, UT 84060 | 2015-09-18 |
1174904924 | Julie Anna Bullen | Counselor | 2300 Monitor Drive, Park City, UT 84060 | 2015-06-17 |
1265825319 | William Gary Smith | Obstetrics & Gynecology | 2501 Creek Drive, Park City, UT 84060 | 2015-03-13 |
1497026330 | Earl Warren Stadler Jr. | Physical Medicine & Rehabilitation | 1500 Three Kings Drive Unit 31, Park City, UT 84060 | 2012-01-24 |
1538454541 | Belinda Duncan | Pharmacist | 2700 E Deer Valley Dr B105, Park City, UT 84060 | 2011-06-17 |
1184888315 | Cody Michael Calderwood | Dentist | 1600 Snow Creek Dr Ste A, Park City, UT 84060 | 2008-07-16 |
Find all providers in zip 84060 |
Taxonomy Code | 207QS0010X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Specialization | Sports Medicine |
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720169915 | Stuart Eliot Willick | Family Medicine | 1493 Lowell Ave, Park City, UT 84060 | 2006-10-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053702431 | Weber State University | Family Medicine | 1001 University Cir, Ogden, UT 84408-5525 | 2015-02-06 |
1043210248 | Trek Lyons | Family Medicine | 1300 N 500 E, Suite 130, Logan, UT 84341-2408 | 2005-07-28 |
1316323165 | Dixie State University | Family Medicine | 225 S 700 E, St George, UT 84770-3875 | 2015-08-04 |
1285013987 | Sportsmed Associates LLC | Family Medicine | 3401 N Center St, Ste 100, Lehi, UT 84043-7497 | 2015-05-27 |
1164826665 | University of Utah Adult Services | Family Medicine | 555 Foothill Dr, Salt Lake City, UT 84112-1106 | 2014-10-14 |
1164860573 | Brett Wayne Martindale | Family Medicine | 4700 Harrison Blvd, Ogden, UT 84403-4303 | 2013-06-07 |
1053631069 | Tye Harrison | Family Medicine | 1350 N 500 E, Logan, UT 84341-2400 | 2010-06-02 |
1720303837 | Nicholas E Monson | Family Medicine | 2132 N 1700 W, 230, Layton, UT 84041-7057 | 2010-03-31 |
1346478476 | Ryan Albert Slater | Family Medicine | 1184 E 80 N, American Fork, UT 84003-2906 | 2009-06-26 |
1922232867 | Christopher R. Gordon | Family Medicine | 1157 N 300 W, Provo, UT 84604-6124 | 2009-05-06 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on DR. MARK WILLIAM 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.