MR. PAUL DENNIS PETERSON (NPI# 1619296894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619296894 |
| Entity Type | Individual |
| Full Name | MR. PAUL DENNIS PETERSON |
| Practice Address |
600 Macinnes Dr Houghton MI 49931-1144 |
| Practice Telephone | 9064831818 |
| Practice Fax Number | 9064831811 |
| Mailing Telephone | 9064831818 |
| Mailing Fax Number | 9064831811 |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2010-05-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 5302020575 | MI | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134769979 | Paul Peterson | Non-emergency Medical Transport (VAN) | 4314 45th St N, Fargo, ND 58102-6915 | 2020-01-09 |
| 1013304500 | Paul Carlton Peterson | Home Health Aide | 712 4th St Ne, Washington, DC 20002-4316 | 2015-04-22 |
| 1083902126 | Paul H Peterson | Podiatrist | 1420 109th Ave Ne Ste 100, Blaine, MN 55449-3603 | 2011-07-11 |
| 1245498971 | Paul Stephen Peterson | Physician Assistant | 5731 Silverstone Ter Ste 100, Colorado Springs, CO 80919-3594 | 2008-05-29 |
| 1285752642 | Paul Arthur Peterson | Specialist/Technologist | 46400 Algonkian Pkwy, Potomac Falls, VA 20165-6487 | 2007-03-26 |
| 1528114667 | Paul Joseph Peterson | Social Worker | 1459 N Main St Ste 100, Bountiful, UT 84010-6092 | 2007-01-25 |
| 1194876672 | Paul Gabriel Peterson | Student in an Organized Health Care Education/Training Program | Wramc Department of Radiology, 6900 Georgia Ave. Nw, Bldg. 2, Washington, DC 20307-0001 | 2007-01-13 |
| 1972678993 | Paul Stanley Peterson | Chiropractor | 4616 El Camino Ave, Sacramento, CA 95821-6736 | 2006-11-22 |
| 1275646465 | Paul J Peterson | Social Worker | 102 Southend Dr, Dayton, NV 89403-7414 | 2006-08-15 |
| 1326013426 | Paul D Peterson | Family Medicine | 2600 Outer Dr N, Sioux City, IA 51104-1585 | 2006-02-22 |
| Street Address |
600 MACINNES DR |
| City | HOUGHTON |
| State | MI |
| Zip Code | 49931-1144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861463994 | Cynthia J. Blake | Nurse Practitioner | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2006-01-27 |
| 1487157103 | Monica Anne Aho | Physical Therapist | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2018-03-09 |
| 1629592647 | Stephanie Ann Bonenfant | Physician Assistant | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2017-08-01 |
| 1619304615 | Portage Physician Practices Inc | Clinic/Center | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2013-10-04 |
| 1902126998 | Todd W Anderson | Family Medicine | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2010-06-02 |
| 1063748770 | Portage Health Inc. | Family Medicine | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2009-10-30 |
| 1891942769 | Melissa A Vertin | Physician Assistant | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2008-08-22 |
| 1093979700 | Zachariah Matthew Deyoung | Family Medicine | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2008-07-11 |
| 1982801569 | Karen Marie Deyoung | Family Medicine | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2007-06-28 |
| 1356475289 | Annette Kristiin Keranen | Physical Therapy Assistant | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2007-03-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962053447 | Meghan Lawler Immel | Counselor | 47431 St. Hwy M26 Unit 1, Suite 2, Houghton, MI 49931 | 2019-09-25 |
| 1205495710 | Public Counseling Services, LLC | Counselor | 47431 Hwy M26 Unit 1, Suite 2, Houghton, MI 49931 | 2019-06-08 |
| 1679047278 | Margiejo D Packham | Registered Nurse | 109 W Memorial Dr, Hancock, MI 49931 | 2019-01-16 |
| 1487150165 | Taylor Lee Douglas | Optometrist | 900 W Mem Dr, Houghton, MI 49931 | 2018-04-02 |
| 1033640867 | Larry Binoniemi | Pharmacist | 995 Razoback Dr, Houghton, MI 49931 | 2017-03-23 |
| 1013247972 | Portage Health Inc | General Practice | 921 W Sharon Ave., Houghton, MI 49931 | 2009-12-28 |
| 1508001629 | Aspirus Keweenaw | General Practice | 900 Memorial Drive, Houghton, MI 49931 | 2008-12-03 |
| 1306027057 | Gary Kilpela | Psychologist | 301 West Lake Ave., Suite 2, Houghton, MI 49931 | 2007-11-23 |
| 1811186455 | Baraga-houghton-keweenaw Child Development Board | Public Health or Welfare | 700 Park Avenue, Houghton, MI 49931 | 2007-10-19 |
| 1922294107 | Diane Sue Johnson | Registered Nurse | 901 West Memorial Drive, Houghton, MI 49931 | 2007-09-20 |
| Find all providers in zip 49931 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033640867 | Larry Binoniemi | Pharmacist | 995 Razoback Dr, Houghton, MI 49931 | 2017-03-23 |
| 1295360907 | Candace Silvola | Pharmacist | 1007 Memorial Dr, Houghton, MI 49931 | 2020-03-03 |
| 1356972020 | Peggy Groeneveld | Pharmacist | 1000 Cedar St, Houghton, MI 49931-1978 | 2020-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477710 | Alix Sabbagh | Pharmacist | 154 River Ln, Dearborn, MI 48124-1047 | 2020-11-04 |
| 1659972867 | Bruce Alan Gilmore | Pharmacist | 5940 Augusta Ln, Grand Blanc, MI 48439-9473 | 2020-11-04 |
| 1437750551 | Anamiben R Patel | Pharmacist | 45555 Michigan Ave, Canton, MI 48188-2388 | 2020-11-04 |
| 1871194217 | Rajesh Koduru | Pharmacist | 27496 Pamplona Ln, Novi, MI 48374-4208 | 2020-11-03 |
| 1346841962 | Joy Emery | Pharmacist | 1770 N Alger Road, Alma, MI 48001 | 2020-11-02 |
| 1659972107 | Jane Gruenke | Pharmacist | N10305 Country Club Rd, Ironwood, MI 49938-9627 | 2020-11-02 |
| 1407456254 | Bradley Dwane Murphy | Pharmacist | 6170 S Saginaw, Grand Blanc, MI 48439 | 2020-10-30 |
| 1811597602 | Rachel L Martin | Pharmacist | 600 N Center Ave, Gaylord, MI 49735-1506 | 2020-10-29 |
| 1760081467 | Sam Nasser | Pharmacist | 6610 Reuter St, Dearborn, MI 48126-1898 | 2020-10-22 |
| 1427656990 | Tejal Shah | Pharmacist | 1153 Pembroke Dr, Rochester Hills, MI 48307-5756 | 2020-10-15 |
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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.