JOHN WILLIAM PETERSEN (NPI# 1588868939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588868939 |
| Entity Type | Individual |
| Full Name | JOHN WILLIAM PETERSEN |
| Credential | MD |
| Practice Address |
1600 Sw Archer Rd Gainesville FL 32610-3003 |
| Mailing Address |
Po Box 918025 Orlando FL 32891-8025 |
| Practice Telephone | 3522739065 |
| Practice Fax Number | 3523923606 |
| Mailing Telephone | 3522739065 |
| Mailing Fax Number | 3523923606 |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2010-09-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 122247 | NC | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
ME105059 | FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962646224 | John Thomas Petersen | Registered Nurse | 1901 Medi Park Dr Ste 2051, Amarillo, TX 79106-2169 | 2009-04-29 |
| 1497973630 | John Robert Petersen | Chiropractor | 2216 County Road D W, Saint Paul, MN 55112-7500 | 2007-04-23 |
| 1720110737 | John William Petersen | Chiropractor | 12000 Elm Creek Blvd N Ste L70, Maple Grove, MN 55369-7167 | 2007-03-12 |
| 1851491526 | John Anthony Petersen | Psychologist | 922 E Wayne St # 205, South Bend, IN 46617-3024 | 2006-09-23 |
| 1790786895 | John Peter Petersen | Radiology | 3555 10th Court, Indian River Regional Cancer Center, Irmc, Vero Beach, FL 32960-4862 | 2005-08-10 |
| 1508422411 | John Robert Petersen | Dentist | 4555 Erin Dr, Eagan, MN 55122-3398 | 2019-05-15 |
| 1619361805 | John Devin Petersen | Pediatrics | 757 Westwood Plz, B711 Rrumc, Los Angeles, CA 90095-7419 | 2015-03-25 |
| 1841587854 | John Roger Petersen | Pathology | 301 University Blvd, Galveston, TX 77555-0551 | 2011-06-29 |
| 1114167434 | John Seigfred Petersen | Dentist | 415 Central Ave, Whitefish, MT 59937-2770 | 2009-02-26 |
| 1164580429 | John J Petersen | Physician Assistant | 520 Medical Center Dr, Suite 201, Medford, OR 97504-4334 | 2006-12-05 |
| Street Address |
1600 SW ARCHER RD |
| City | GAINESVILLE |
| State | FL |
| Zip Code | 32610-3003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669475554 | Walter J Milton | Radiology | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2005-05-24 |
| 1104427251 | Morgan Elizabeth Gilbert | Nurse Practitioner | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-11-05 |
| 1598365306 | Kristin Renee Lapham | Nurse Practitioner | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-10-30 |
| 1225638174 | Leigha Fridley | Student in an Organized Health Care Education/Training Program | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-10-29 |
| 1962000950 | Kelli O'shaughnessy | Physician Assistant | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-10-13 |
| 1053919985 | Amber Lynn Bart | Nurse Practitioner | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-10-13 |
| 1134726847 | Emily Elizabeth Farhat | Social Worker | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-10-06 |
| 1346847944 | Nicholas Scott Duarte | Physician Assistant | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-10-06 |
| 1922613231 | Trinh Nguyen | Pharmacist | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-09-14 |
| 1053926501 | Annalise Deboef | Nurse Practitioner | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003440660 | Thy Cam Huynh | Occupational Therapist | 1549 Gale Lemerand Dr, Gainesville, FL 32610 | 2020-02-23 |
| 1093359226 | Lauren Anne Ruddocks | Dentist | University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL 32610 | 2019-10-31 |
| 1104310549 | Brandon Lucke-wold | Neurological Surgery | 1149 S Newell Dr Deapartment of Neurosurgery Bldg #59, Gainesville, FL 32610 | 2018-06-19 |
| 1619465754 | Carlos Eduardo Vervloet Sollero | Student in an Organized Health Care Education/Training Program | 1149 Newell Drive, University of Florida, Department of Neurology, Gainesville, FL 32610 | 2018-04-24 |
| 1811359151 | Ramsha A. Kudia | Internal Medicine | 1549 Gale Lemerand Drive, 3rd Floor, Gainesville, FL 32610 | 2016-03-25 |
| 1447619937 | Wajdi Mohammed | Dentist | 1395 Center Dr., D8-6, Gainesville, FL 32610 | 2016-02-12 |
| 1922484344 | Kavan Ashit Gandhi | Dentist | 1395 Center Drive D7-19, Gainesville, FL 32610 | 2015-08-07 |
| 1972981512 | David Shin | Student in an Organized Health Care Education/Training Program | 1600 Sw Archer Road, Fl 1, Rm 1097, Gainesville, FL 32610 | 2015-05-15 |
| 1669887485 | Alejandro Jose Delgado | Dentist | 1395 Center Drive, University of Florida, College of Dentistry, Gainsville, FL 32610 | 2014-07-01 |
| 1194167296 | Zain Shahid | Student in an Organized Health Care Education/Training Program | 1600 Sw Archer Rd # Ng-45, Gainesville, FL 32610 | 2013-07-18 |
| Find all providers in zip 32610 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427690775 | The Cardiac and Vascular Institute Ambulatory Surgery Center | Internal Medicine | 4645 Nw 8th Ave Ste 10, Gainesville, FL 32605-4688 | 2019-10-08 |
| 1639213101 | James B Destephens Md Pa | Internal Medicine | 2341 Nw 41st St Ste B, Gainesville, FL 32606-7442 | 2007-02-17 |
| 1861583833 | Mark Velpeau Barrow Sr. | Internal Medicine | 1731-b Nw 6th Steet, Gainesville, FL 32609-3531 | 2006-09-27 |
| 1881650836 | James J Nelson Md Pa | Internal Medicine | 3720 Nw 83rd St, Gainesville, FL 32606-5603 | 2006-04-26 |
| 1902871155 | David P Johnson | Internal Medicine | 535 Jesse Jewell Parkway, Suite C, Gainesville, GA 30501 | 2006-02-21 |
| 1982684460 | James Bruce Destephens | Internal Medicine | 2341 Nw 41st St, Suite B, Gainesville, FL 32606-7494 | 2006-01-19 |
| 1497730428 | Khawaja N Anwar | Internal Medicine | 1902 Hospital Blvd Ste F, Gainesville, TX 76240-2008 | 2005-12-13 |
| 1255313649 | Southern Cardiac Interpretation Pa | Internal Medicine | 350 Nw 76th Dr, Suite B, Gainesville, FL 32607-6662 | 2005-11-19 |
| 1760484562 | Masih Uddin | Internal Medicine | 1475 Jesse Jewell Pkwy Ne Ste 300, Gainesville, GA 30501 | 2005-08-11 |
| 1679572069 | Sudhakara Babu Chennareddy | Internal Medicine | 200 S Enota Dr Ne Ste 100, Gainesville, GA 30501-3466 | 2005-07-18 |
| Find all providers in GAINESVILLE | ||||
| City | GAINESVILLE |
| Zip Code | 32610 |
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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.