DR. ROBERT G PETERSON (NPI# 1497715163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497715163 |
| Entity Type | Individual |
| Full Name | DR. ROBERT G PETERSON |
| Credential | M.D. |
| Practice Address |
370 Ninth Ave Suite 111 Salt Lake City UT 84103-2877 |
| Mailing Address |
Po Box 27128 Salt Lake City UT 84127-0128 |
| Practice Telephone | 8014082233 |
| Practice Fax Number | 8014082870 |
| Mailing Telephone | 8014421900 |
| Enumeration Date | 2006-03-25 |
| Last Update Date | 2011-09-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 1800341205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | INTERMOUNTAIN HEALTHCARE | 107004866104 | 01 |
| UT | EDUCATORS MUTUAL (EMIA) | 870639983PE2 | 01 |
| UT | PUBLIC EMPLOYEES (PEHP) | 18541 | 01 |
| UT | DESERET MUTUAL (DMBA) | 20110 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902206683 | Robert Peterson | Otolaryngology | 3921 E Nora Cir, Mesa, AZ 85215-1077 | 2014-08-29 |
| 1255605911 | Robert Dennis Peterson | Acupuncturist | 1214 S Alma St, #5, San Pedro, CA 90731-3949 | 2012-02-28 |
| 1295006419 | Robert Michael Peterson Jr. | Dentist | 747 W. Devon, Park Ridge, IL 60068 | 2012-01-19 |
| 1871822361 | Robert Curt Peterson | Psychologist | 5041 Warm Springs Rd Ste C, Columbus, GA 31909-6938 | 2009-12-14 |
| 1285849067 | Robert Kenneth Peterson | Licensed Practical Nurse | 5979 Renner Rd, Columbus, OH 43228-9588 | 2007-05-14 |
| 1467581025 | Robert Jason Peterson | Preventive Medicine | 1614 Wrightstown Rd, Newtown, PA 18940-2814 | 2007-03-02 |
| 1437294923 | Robert Schaefer Peterson | Psychologist | 865 Hilltop Road, Erie, PA 16509-2153 | 2007-02-21 |
| 1518010636 | Robert Lee Peterson | Case Manager/Care Coordinator | 915 S Mckinley St, Casper, WY 82601-3440 | 2007-01-19 |
| 1720144876 | Robert Lester Peterson | Family Medicine | 900 Riverside Dr, Suite IIi, Waupaca, WI 54981-1983 | 2006-12-30 |
| 1982768040 | Robert James Peterson | Optometrist | 4306 W Crystal Lk Road, Mchenry, IL 60050-4294 | 2006-12-21 |
| Street Address |
370 NINTH AVE SUITE 111 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84103-2877 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568902591 | Larry A Sargent, Md,pllc | Plastic Surgery | 370 Ninth Ave, Suite 200, Salt Lake City, UT 84103-2877 | 2017-02-23 |
| 1629249495 | Robert G Peterson, Md, PC | Neurological Surgery | 370 Ninth Ave, Ste 111, Salt Lake City, UT 84103-2877 | 2008-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932509213 | Paul David Rauch | Specialist/Technologist | 701 De Soto Street, Salt Lake City, UT 84103 | 2014-08-24 |
| 1073866695 | University Neuropsychiatric Institute | Community Based Residential Treatment Facility, Mental Illness | 252 South 500 East, Salt Lake City, UT 84103 | 2012-10-19 |
| 1114285558 | Christopher John Murphy | Student in an Organized Health Care Education/Training Program | 585 1st Ave, Salt Lake City, UT 84103 | 2012-04-23 |
| 1447573266 | Peter Louis Kapelke | Specialist | Fairfax Rd. @ Virginia St., Shriners Hospital Salt Lake City, Salt Lake City, UT 84103 | 2010-03-08 |
| 1578763389 | Susana Auhangamea Kinikini | Nurse Practitioner | Fairfax @ Virginia Street, Salt Lake City, UT 84103 | 2007-07-19 |
| 1609082320 | Cynthia N Shumway | Social Worker | 580 10th Avenue, Salt Lake City, UT 84103 | 2007-05-16 |
| 1811010655 | Kent Walker Farnsworth | Obstetrics & Gynecology | 1509 Federal Heights Drive, Salt Lake City, UT 84103 | 2007-04-09 |
| 1912082421 | Eloise Agnes Maughan | Nurse Practitioner | 324 8th Ave, Lds Hospital, Salt Lake City, UT 84103 | 2006-10-25 |
| 1407968464 | Kit D Smith | Anesthesiology | 359 - 8th Avenue, Asc, Salt Lake City, UT 84103 | 2006-08-31 |
| 1396854113 | Lisa H Carter | Physical Therapist | 1285 East Fairfax Road, Salt Lake City, UT 84103 | 2006-08-29 |
| Find all providers in zip 84103 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073975660 | Robert Kim | Neurological Surgery | 175 N Medical Drive East 5th Floor, Salt Lake City, UT 84132-0001 | 2016-03-23 |
| 1689819146 | James Leo Mcgauley | Neurological Surgery | 8884 Alpen Way, Salt Lake City, UT 84121-6159 | 2008-12-11 |
| 1861645087 | Sarah Tamara Menacho | Neurological Surgery | 175 North Medical Drive East, 5th Floor, University of Utah Department of Neurosurgery, Salt Lake City, UT 84132-0001 | 2008-10-31 |
| 1437331592 | Dr Diana D Banks, LLC | Neurological Surgery | 5323 South 120 West, Suite 201, Salt Lake City, UT 84107 | 2007-11-30 |
| 1730249582 | James C Pingree | Neurological Surgery | 1220 E 3900 S Ste 4e, Salt Lake City, UT 84124-1343 | 2006-12-11 |
| 1235219130 | Richard H. Schmidt | Neurological Surgery | 175 N Medical Dr Fl 5, Salt Lake City, UT 84132-2303 | 2006-10-16 |
| 1487744090 | Joel Douglas Macdonald | Neurological Surgery | 82 S 1100 E Ste 103, Salt Lake City, UT 84102-1889 | 2006-10-13 |
| 1336239920 | Kenneth Stephen Yonemura | Neurological Surgery | 6360 S 3000 E Ste 210, Salt Lake City, UT 84121-6972 | 2006-10-13 |
| 1053320754 | Paul Gregory Amstutz | Neurological Surgery | 500s Foothill Blvd, Salt Lake City, UT 84148-0001 | 2006-08-05 |
| 1053325365 | Jodie Karen Levitt | Neurological Surgery | 1327 East 2100 South, Suite 101, Salt Lake City, UT 84105 | 2006-07-29 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84103 |
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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.