MARC ZEPHIRE PETERSON (NPI# 1609323260) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609323260 |
| Entity Type | Individual |
| Full Name | MARC ZEPHIRE PETERSON |
| Credential | CRNA |
| Practice Address |
101 Civic Center Lane Havasu Regional Medical Center Lake Havasu AZ 86403 |
| Mailing Address |
2770 Squall King Dr Lake Havasu City AZ 86404-3304 |
| Practice Telephone | 9285055760 |
| Mailing Telephone | 8018703968 |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-11-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN202234 | AZ | Nursing Service Providers |
| N | 163W00000X | Registered Nurse | 5909731-3102 | UT | Nursing Service Providers |
| N | 163W00000X | Registered Nurse | 14-126823-061 | KS | Nursing Service Providers |
| Y | 367500000X | Nurse Anesthetist, Certified Registered | CRNA1248 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083783237 | Marc R Peterson | Physician Assistant | 1515 S Phillips St, Algona, IA 50511-3649 | 2006-11-06 |
| Street Address |
101 CIVIC CENTER LANE HAVASU REGIONAL MEDICAL CENTER |
| City | LAKE HAVASU |
| State | AZ |
| Zip Code | 86403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104479039 | Liska's Apothecary Shop, Inc. | Assisted Living Facility | 1840 Mesquite Ave., Ste. E, Lake Havasu City, AZ 86403 | 2019-07-19 |
| 1275033227 | Ayad Costy | Pharmacist | 75 North Lake Havasu City, Lake Havasu City, AZ 86403 | 2018-02-16 |
| 1942727250 | Ideal Health Care, L.L.C. | Prosthetic/Orthotic Supplier | 1675 Mesquite Ave Ste A, Lake Havasu City, AZ 86403 | 2017-08-28 |
| 1063965036 | Cerner Health Connections, Inc | Clinic/Center | 89 Civic Center Blvd, Lake Havasu City, AZ 86403 | 2016-07-26 |
| 1447643358 | Lundin Dental PC | Durable Medical Equipment & Medical Supplies | 1741 Mesquite Avenue Ste B 100, Lake Havasu City, AZ 86403 | 2015-03-17 |
| 1912301425 | Arizona Havasu Bdm Pak LLC | Dentist | 1799 North Kiowa Blvd, Unit 109, Lake Havasu, AZ 86403 | 2014-10-13 |
| 1386047850 | Emily E Vona | Nurse Practitioner | 84 Acoma Blvd N Ste 104, Lake Havasu City, AZ 86403 | 2014-09-29 |
| 1750700589 | Thomas Wennergren | Pharmacist | 25 S Lake Havasu Ave, Lake Havasu City, AZ 86403 | 2014-04-09 |
| 1285997460 | Jamie L Lemire | Pharmacist | 1980 Mcculloch Blvd, Lake Havasu City, AZ 86403 | 2012-06-21 |
| 1053694448 | Goodwill of Northern Arizona | Exclusive Provider Organization | 1990 Mcculloch Blvd North, Lake Havasu City, AZ 86403 | 2011-09-22 |
| Find all providers in zip 86403 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740895994 | Kelli Dee Gleason | Nurse Anesthetist, Certified Registered | 8339 E Vista Dr, Scottsdale, AZ 85250-7321 | 2020-09-14 |
| 1164032249 | John Durkin | Nurse Anesthetist, Certified Registered | 2000 E Southern Ave Ste 105, Tempe, AZ 85282-7510 | 2020-08-04 |
| 1376182758 | Native Anesthesia LLC | Nurse Anesthetist, Certified Registered | 2747 E University Dr, Mesa, AZ 85213-8437 | 2020-01-02 |
| 1003453408 | Kevin L Olena Crna, Pllc | Nurse Anesthetist, Certified Registered | 3432 E Georgia Ave, Phoenix, AZ 85018-1501 | 2019-12-04 |
| 1144863549 | As Needed Anesthesia | Nurse Anesthetist, Certified Registered | 4045 E Bell Rd Ste 127, Phoenix, AZ 85032-2234 | 2019-10-18 |
| 1740831775 | Jared Thirjung | Nurse Anesthetist, Certified Registered | 1718 W Colter St Unit 172, Phoenix, AZ 85015-2955 | 2019-09-20 |
| 1376001925 | Kevin Lee | Nurse Anesthetist, Certified Registered | 305 N Martin Ave, Tucson, AZ 85721-0001 | 2019-03-03 |
| 1669959235 | Erin Galligan | Nurse Anesthetist, Certified Registered | 1501 N Campbell, Tucson, AZ 85721-0001 | 2018-07-25 |
| 1417442799 | Prop Anesthesia LLC | Nurse Anesthetist, Certified Registered | 9250 W Thomas Rd Ste 220, Phoenix, AZ 85037 | 2018-06-28 |
| 1144748906 | Mountain West Anesthesia Pllc | Nurse Anesthetist, Certified Registered | 20940 N Tatum Blvd Ste 100, Phoenix, AZ 85050-7259 | 2017-08-31 |
| Find all providers with the same taxonomy | ||||
| City | LAKE HAVASU |
| Zip Code | 86403 |
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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.