HENRY PETERSEN (NPI# 1346781275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346781275 |
| Entity Type | Individual |
| Full Name | HENRY PETERSEN |
| Practice Address |
5829 Kenwood Ave Dallas TX 75206-5589 |
| Practice Telephone | 8187466505 |
| Mailing Telephone | 8187466505 |
| Enumeration Date | 2017-03-11 |
| Last Update Date | 2017-03-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891123543 | Henry Petersen | Physician Assistant | 700 W Ironwood Dr, Ste 320, Coeur D Alene, ID 83814-2656 | 2013-10-16 |
| 1053665182 | Henry Soron Petersen | Social Worker | 4550 Kearny Villa Rd Ste 116, San Diego, CA 92123-1583 | 2012-10-26 |
| Street Address |
5829 KENWOOD AVE |
| City | DALLAS |
| State | TX |
| Zip Code | 75206-5589 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316596919 | Dallas Anesthesia Group, Pllc | Anesthesiology | 5706 E. Mockingbird Ln, Ste 115, Dallas, TX 75206 | 2019-09-06 |
| 1003398074 | Aaron Hands | Psychologist | 5646 Milton St Ste 740, Dallas, TX 75206 | 2018-09-05 |
| 1174001960 | Robert Butler Hampson | Psychologist | 5910 N. Central Expressway, Suite 1820, Dallas, TX 75206 | 2018-08-02 |
| 1851890636 | Old Town Endoscopy Center LLC | Nurse Anesthetist, Certified Registered | 5500 Greenville Avenue Suite 1100, Dallas, TX 75206 | 2018-02-07 |
| 1851830434 | Amanda Rash | Physical Therapy Assistant | 5855 Milton Road, Dallas, TX 75206 | 2017-02-16 |
| 1649727272 | Insights Psychotherapy Group, Pllc | Counselor | 5255 Vickery Boulevard, Dallas, TX 75206 | 2016-09-01 |
| 1215389655 | Revolution Monitoring Management, LLC | Psychiatry & Neurology | 4925 Greenville Ave #200, Dallas, TX 75206 | 2016-07-11 |
| 1225413776 | Chelsea Young | Speech-Language Pathologist | 8820 Southwestern Blvd #605, Dallas, TX 75206 | 2015-07-27 |
| 1861802332 | Shane Ahlers | Internal Medicine | 6037 Marquita Ave, Dallas, TX 75206 | 2014-05-05 |
| 1417386442 | Inspire Pediatric Therapy | Speech-Language Pathologist | 5646 Milton, #307, Dallas, TX 75206 | 2013-11-12 |
| Find all providers in zip 75206 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760098271 | Danielle Mortimer | Student in an Organized Health Care Education/Training Program | 1340 Prudential Dr Ste A, Dallas, TX 75235-4115 | 2020-09-20 |
| 1114536331 | Victor Liaw | Student in an Organized Health Care Education/Training Program | 5233 Harry Hines Blvd, Dallas, TX 75390-9006 | 2020-07-23 |
| 1285243469 | Tommy Tan | Student in an Organized Health Care Education/Training Program | 5226 Fleetwood Oaks Ave Apt 114, Dallas, TX 75235-8105 | 2020-07-23 |
| 1982213138 | Sophia Cosmich | Student in an Organized Health Care Education/Training Program | Ut Southwestern Medical School 5325 Harry Hines Blvd, Dallas, TX 75390-9006 | 2020-07-23 |
| 1093323552 | Joshua D Cox | Student in an Organized Health Care Education/Training Program | 2222 Medical District Dr Apt 4315, Dallas, TX 75235-8054 | 2020-07-21 |
| 1386252997 | Johnston Bartlett Norton | Student in an Organized Health Care Education/Training Program | 4214 Rawlins St Apt 116, Dallas, TX 75219-2738 | 2020-07-20 |
| 1063020014 | Bilaal Hassan | Student in an Organized Health Care Education/Training Program | Ut Southwestern Medical Center 5323 Harry Hines Blvd D, Dallas, TX 75390-0001 | 2020-07-15 |
| 1255959805 | Richard Tanner Hardy | Student in an Organized Health Care Education/Training Program | Ut Southwestern Medical Center 5323 Harr Hines Blvd, Dallas, TX 75390-0001 | 2020-07-09 |
| 1902424534 | Paula Marie Mofor | Student in an Organized Health Care Education/Training Program | Ut Southwestern Medical School 5323 Harry Hines Blvd, Dallas, TX 75390-9006 | 2020-07-09 |
| 1912525015 | Yasmeen Jordan Alayli | Student in an Organized Health Care Education/Training Program | 4606 Cedar Springs Rd Apt 924, Dallas, TX 75219-7205 | 2020-07-06 |
| Find all providers in DALLAS | ||||
Please comment or provide details below to improve the information on HENRY PETERSEN.
| 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.