MR. BENDT P PETERSEN III (NPI# 1477510915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477510915 |
| Entity Type | Individual |
| Full Name | MR. BENDT P PETERSEN III |
| Credential | M.D. |
| Practice Address |
6701 Airport Blvd Building D Suite 100 Mobile AL 36608 |
| Practice Telephone | 2516076117 |
| Practice Fax Number | 2512190746 |
| Mailing Telephone | 2516076117 |
| Mailing Fax Number | 2512190746 |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2019-11-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
00016728 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00126962 | 05 | |
| AL | 051512177 | 05 | |
| TAX ID | 631187140 | 01 | |
| RAILROAD MEDICARE | 200045418 | 01 | |
| AL | BCBS | 051512177 | 01 |
| Street Address |
6701 AIRPORT BLVD BUILDING D SUITE 100 |
| City | MOBILE |
| State | AL |
| Zip Code | 36608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053313312 | Richard O Nenstiel | Physician Assistant | 6701 Airport Blvd, Suite D146, Mobile, AL 36608 | 2005-06-01 |
| 1508392432 | University of South Alabama Health Care Authority | Internal Medicine | 6701 Airport Blvd, A101, Mobile, AL 36608-6705 | 2017-05-11 |
| 1093241671 | Alabama Providence Healthcare Services | Otolaryngology | 6701 Airport Blvd, Suite B123, Mobile, AL 36608-6705 | 2017-05-03 |
| 1588109599 | Citrin Cardiology PC | Internal Medicine | 6701 Airport Blvd, Suite C138, Mobile, AL 36608-3784 | 2016-12-29 |
| 1629511753 | Alabama Providence Healthcare Services | Specialist | 6701 Airport Blvd, Ste B215, Mobile, AL 36608-6705 | 2016-11-21 |
| 1891245692 | Alabama Providence Healthcare Services | Specialist | 6701 Airport Blvd, Suite D143, Mobile, AL 36608-6705 | 2016-10-05 |
| 1386191740 | Leah Ambrose | Physician Assistant | 6701 Airport Blvd, Suite C138, Mobile, AL 36608-6705 | 2016-09-02 |
| 1386093953 | Terra Lynn Parnell | Nurse Practitioner | 6701 Airport Blvd, Suite D-330, Mobile, AL 36608 | 2016-06-06 |
| 1649634395 | Alabama Providence Healthcare Services | Specialist | 6701 Airport Blvd, Suite A-t06, Mobile, AL 36608-6705 | 2016-04-08 |
| 1558725200 | Alabama Providence Healthcare Services | Specialist | 6701 Airport Blvd, Suite B329, Mobile, AL 36608-6705 | 2016-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475524 | Grantham Dental, Inc. | Dentist | 3620 Springhill Memorial Drive South, Mobile, AL 36608 | 2020-10-21 |
| 1114540879 | Dearrius Hines | Home Health Aide | 1370 Lucerne Dr, Mobile, AL 36608 | 2020-05-28 |
| 1558980409 | Rachel Stevens | Registered Nurse | 8507 Tanner Williams Rd, Mobile, AL 36608 | 2020-04-10 |
| 1073170700 | Usa Health Physician Billing Services LLC | Otolaryngology | 5721 Usa Drive North, Hahn 1119, Mobile, AL 36608 | 2019-05-29 |
| 1952885600 | Franklin Primary Health Center Inc. | Dentist | 990 Cody Rd North, Mobile, AL 36608 | 2018-09-19 |
| 1114410040 | Zackary Elkins | Optometrist | 105 W I65 Service Rd N, Mobile, AL 36608 | 2018-06-14 |
| 1023562865 | Covenant Hospice, Inc. | Internal Medicine | 6801 Airport Blvd., Main Tower, 11th Floor North, Mobile, AL 36608 | 2016-08-10 |
| 1730575416 | Rayven Likely | Student in an Organized Health Care Education/Training Program | 1014 Centerwood Dr, Mobile, AL 36608 | 2015-04-09 |
| 1598040461 | Robert S Harlin | Specialist | 75 Clarise Circle, Mobile, AL 36608 | 2011-10-11 |
| 1972884948 | Heidi Michelle Mcdermott | Physical Therapist | 5721 Usa Drive N, Hahn 2050, Mobile, AL 36608 | 2011-09-06 |
| Find all providers in zip 36608 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639710882 | Petersen Neurospine, Pllc | Orthopaedic Surgery | 6701 Airport Blvd Ste D100, Mobile, AL 36608-6765 | 2019-09-30 |
| 1396244307 | Select Health of Al, LLC | Orthopaedic Surgery | 202a Government St, Mobile, AL 36602-2614 | 2018-02-05 |
| 1497254403 | Joint Replacement Cin of Mobile LLC | Orthopaedic Surgery | 202b Government St, Mobile, AL 36602-2614 | 2018-02-05 |
| 1679521785 | James Lee West IIi | Orthopaedic Surgery | 6144 Airport Blvd, Mobile, AL 36608-3143 | 2006-05-04 |
| 1518924232 | Todd Kramer Volkman | Orthopaedic Surgery | 6144 Airport Blvd, Mobile, AL 36608-3143 | 2006-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801310362 | Kivanc Atesok | Orthopaedic Surgery | Uab Division of Orthopaedic Surgery 510 20th, Birmingham, AL 35294-0001 | 2017-07-26 |
| 1467755405 | University Orthopaedic Clinic, PC | Orthopaedic Surgery | 241 Robert K Wilson Drive, Carrolton, AL 35447-0478 | 2010-12-14 |
| 1871713032 | Obrien Orthopedic PC | Orthopaedic Surgery | 6490 Highway 72, Athens, AL 35645 | 2007-04-27 |
| 1689723868 | Timothy A. Holt | Orthopaedic Surgery | 257 Winton M Blount Loop, Montgomery, AL 36117-3507 | 2007-01-09 |
| 1356325138 | Southeastern Spine Specialists Inc | Orthopaedic Surgery | 1781 Commons North Loop, Tuscaloosa, AL 35406-3577 | 2005-12-05 |
| 1053807230 | Chong Weng | Orthopaedic Surgery | 510 20th St S, Birmingham, AL 35233-2028 | 2018-07-10 |
| 1437411675 | John Rodriguez-feo IIi | Orthopaedic Surgery | 927 Franklin St Se, Huntsville, AL 35801-4306 | 2012-06-13 |
| 1275825135 | Charles Marvin Gordon Jr. | Orthopaedic Surgery | 1505 Daphne Ave, Daphne, AL 36526 | 2011-05-11 |
| 1477661056 | Zenko J Hrynkiw, Md, PC | Orthopaedic Surgery | 720 Montclair Rd, Suite 201, Birmingham, AL 35213-1964 | 2006-08-25 |
| 1992812887 | Harry B. Wheelock Jr. | Orthopaedic Surgery | 48 Medical Park Dr E, Suite 255, Birmingham, AL 35235-3400 | 2006-08-24 |
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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.