DR. LUKE TYLER PETERSON (NPI# 1659698967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659698967 |
| Entity Type | Individual |
| Full Name | DR. LUKE TYLER PETERSON |
| Credential | M.D. |
| Practice Address |
825 Ridge Lake Blvd Memphis TN 38120-9411 |
| Practice Telephone | 9016852200 |
| Practice Fax Number | 9018202342 |
| Mailing Telephone | 9016852200 |
| Mailing Fax Number | 9018202342 |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2018-01-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | E-9417 | AR | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | 23966 | MS | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | 53018 | TN | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | 072079 | GA | Allopathic & Osteopathic Physicians |
| N | 207WX0009X |
Ophthalmology Specialization: Glaucoma Specialist |
E9417 | AR | Allopathic & Osteopathic Physicians |
| N | 207WX0009X |
Ophthalmology Specialization: Glaucoma Specialist |
23966 | MS | Allopathic & Osteopathic Physicians |
| Y | 207WX0009X |
Ophthalmology Specialization: Glaucoma Specialist |
53018 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 210764001 | 05 | |
| MS | 04974576 | 05 | |
| TN | RR MEDICARE | P01621977 | 01 |
| TN | Q013926 | 05 | |
| MS | RR MEDICARE | P01601629 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184789497 | Luke Henry Peterson | Chiropractor | 213 S Swoope Ave, Maitland, FL 32751-5717 | 2006-12-27 |
| 1467689109 | Luke Nuzum Peterson | Otolaryngology | 1836 South Ave, La Crosse, WI 54601-5429 | 2009-06-21 |
| Street Address |
825 RIDGE LAKE BLVD |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38120-9411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851395446 | James A Savage | Ophthalmology | 825 Ridge Lake Blvd, Memphis, TN 38120-9411 | 2005-06-10 |
| 1285188490 | Desirae Brinkley | Optometrist | 825 Ridge Lake Blvd, Memphis, TN 38120-9411 | 2016-08-05 |
| 1932555919 | Craig Ryan Thiessen | Ophthalmology | 825 Ridge Lake Blvd, Memphis, TN 38120-9411 | 2016-05-10 |
| 1003113606 | Seth Aaron Salley | Optometrist | 825 Ridge Lake Blvd, Memphis, TN 38120-9411 | 2011-02-16 |
| 1326363086 | David Elliot Fingerhut | Ophthalmology | 825 Ridge Lake Blvd, Memphis, TN 38120-9411 | 2010-04-06 |
| 1003146630 | Barbara A Overbey | Nurse Practitioner | 825 Ridge Lake Blvd, Memphis, TN 38120-9411 | 2010-01-04 |
| 1952500373 | Andrew W Crothers | Ophthalmology | 825 Ridge Lake Blvd, Memphis, TN 38120-9411 | 2007-07-16 |
| 1578761011 | Calvin Christopher Brown IIi | Ophthalmology | 825 Ridge Lake Blvd, Memphis, TN 38120-9411 | 2007-07-06 |
| 1881810414 | Ridge Lake Anesthesia | Anesthesiology | 825 Ridge Lake Blvd, Memphis, TN 38120-9411 | 2007-04-18 |
| 1801914148 | Lucie S. Elfervig | Nurse Practitioner | 825 Ridge Lake Blvd, Memphis, TN 38120-9411 | 2007-03-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093285637 | Cobblestone Midwifery | Midwife | 5617 Ashley Square South, Memphis, TN 38120 | 2018-11-27 |
| 1649768870 | River City Neuropsychology, Pllc | Psychologist | 1661 International Dr., Suite 400, Memphis, TN 38120 | 2018-04-24 |
| 1841676152 | Jody Lavaun Clements | Dentist | 795 Ridge Lake Blvd Ste 101, Memphis, TN 38120 | 2015-08-10 |
| 1578957122 | Christina Lumpkin | Nurse Practitioner | 6305 Humphreys Blvd Ste 101, Memphis, TN 38120 | 2015-03-21 |
| 1316352099 | Daniel Poor | Emergency Medicine | Baptist Memorial Hospital Memphis, 124 N. Humphrey's Blvd, Memphis, TN 38120 | 2014-06-21 |
| 1245643246 | Kysha Saleem | Nurse Practitioner | 6027 Walnut Grove Rd., Suite 312, Memphis, TN 38120 | 2014-06-06 |
| 1376962613 | John Christopher Swearingen | Dentist | 780 Ridge Lake Blvd Ste 101, Memphis, TN 38120 | 2014-04-15 |
| 1275884645 | Rebecca Leigh Goedecke | Nurse Practitioner | 6215 Humphreys Blvd Ste 301, Memphis, TN 38120 | 2012-09-26 |
| 1730475179 | Sarah Elizabeth Hammond | Surgery | Plastic Surgery Group, 80 Humphreys Blvd #100, Memphis, TN 38120 | 2011-06-23 |
| 1922302785 | Daniel L Hester | Nurse Anesthetist, Certified Registered | 1755 Kirby Parkway Suite 330, Memphis, TN 38120 | 2011-01-07 |
| Find all providers in zip 38120 | ||||
| Taxonomy Code | 207WX0009X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Glaucoma Specialist |
| An ophthalmologist who specializes in the treatment of glaucoma and other disorders related to increased intraocular pressure and optic nerve damage. This specialty involves the medical and surgical treatment of these conditions. |
| Notes: Source: American Academy of Ophthalmology, www.aao.org [1/1/2017: new] Additional Resources: Association of University Professors of Ophthalmology, www.aupo.org |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518961176 | Southeast Eye Specialists Pllc | Ophthalmology | 7268 Jarnigan Rd, Suite 200, Chattanooga, TN 37421-3097 | 2005-06-10 |
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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.