JAMES H PETERSEN (NPI# 1831169275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831169275 |
| Entity Type | Individual |
| Full Name | JAMES H PETERSEN |
| Credential | M.D. |
| Practice Address |
200 Brevco Plz Suite 208 Lake St Louis MO 63367-2949 |
| Practice Telephone | 6365619020 |
| Mailing Telephone | 6365619020 |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2014-07-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
MOR7B69 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1831169275 | 05 | |
| MO | RAILROAD MEDICARE | P01021819 | 01 |
| MO | 202263828 | 05 | |
| MO | BC/BS MISSOURI | 24528 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134439755 | James Tyler Petersen | Chiropractor | 657 W 200 N, Cedar City, UT 84720-2408 | 2010-10-15 |
| 1467672774 | James Lee Petersen | Physician Assistant | 1025 Pennock Pl Ste 1421, Fort Collins, CO 80524 | 2007-04-27 |
| 1306844030 | James G Petersen | Dentist | 607 Ne 3rd St, Prineville, OR 97754-2021 | 2005-07-07 |
| 1467087494 | James Martin Petersen | Social Worker | 137 Holton Whitehall Rd, Whitehall, MI 49461-9543 | 2020-03-10 |
| 1861040735 | James Petersen | Social Worker | 3141 Centennial Blvd, Colorado Springs, CO 80907-4094 | 2019-09-03 |
| 1275022964 | James Mathew Petersen | Physician Assistant | 3730 Plaza Way Ste C6100, Kennewick, WA 99338-2718 | 2018-05-08 |
| 1891140224 | James Petersen | Pharmacist | 2525 Chicago Ave, Inpatient Pharmacy, Minneapolis, MN 55404-4518 | 2016-05-04 |
| 1992145098 | James Robert Petersen | Emergency Medicine | 1407 N Whisenant Dr, Duncan, OK 73533 | 2013-07-03 |
| 1205136157 | James Petersen | Pharmacist | 9101 E Baseline Rd, Mesa, AZ 85209-7758 | 2010-10-26 |
| 1922219641 | James Robert Petersen | Pharmacist | 4000 University Ave, Waterloo, IA 50701-5640 | 2007-05-24 |
| Street Address |
200 BREVCO PLZ SUITE 208 |
| City | LAKE ST LOUIS |
| State | MO |
| Zip Code | 63367-2949 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073505178 | Michael J Zerega | Internal Medicine | 200 Brevco Plz, Suite 208, Lake St Louis, MO 63367-2949 | 2005-08-16 |
| 1528195484 | Layla Hajjafar | Specialist | 200 Brevco Plz, Suite 208, Lake St Louis, MO 63367-2949 | 2007-02-27 |
| 1407960107 | Digestive Disease Medical Consultants, PC | Internal Medicine | 200 Brevco Plz, Suite 208, Lake St Louis, MO 63367-2949 | 2006-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295376697 | Stacy Brown | Counselor | 1216 Flagstone Terrace, Lake St. Louis, MO 63367 | 2019-10-07 |
| 1083172449 | Katie D Schmidt | Nurse Practitioner | 300 Medical Plz Ste 150, Lake St Louis, MO 63367 | 2019-03-05 |
| 1932639739 | Eren Taylor-scaggs | Social Worker | 112 Lake St. Louis Blvd, Lake St. Louis, MO 63367 | 2017-06-14 |
| 1184169203 | Be The Change Counseling Services | Community/Behavioral Health | 206 Centre On The Lake, Lake St. Louis, MO 63367 | 2016-12-28 |
| 1568812535 | Brittanie Weinhaus | Family Medicine | 6261 Ronald Regan Dr Ste #b19, Lake St. Louis, MO 63367 | 2016-06-20 |
| 1821445099 | Matt Beamer | Skilled Nursing Facility | 2885 Technology Drive, Lake St. Louis, MO 63367 | 2016-05-18 |
| 1710349642 | Jennifer Gandolfo | Early Intervention Provider Agency | 710 Abbottsford Ct., Lake St. Louis, MO 63367 | 2016-03-21 |
| 1760862361 | Joaquin Francisco Sumaya | Chiropractor | 11104 Veterans Memorial Pkwy., Lake Saint Louis, MO 63367 | 2015-06-09 |
| 1619214566 | Daniel Scott Terry | Counselor | 1000 Edgewater Pt Ste 401, Lake St Louis, MO 63367 | 2013-01-12 |
| 1437415551 | Cherie Jean Coletta | Nurse Practitioner | 100 Medical Plaza Dr, Emergency Department, Lake Saint Louis, MO 63367 | 2012-04-03 |
| Find all providers in zip 63367 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1073505178 | Michael J Zerega | Internal Medicine | 200 Brevco Plz, Suite 208, Lake St Louis, MO 63367-2949 | 2005-08-16 |
| 1578799235 | Digestive Disease Care Center, LLC | Internal Medicine | 300 Medical Plz, Suite 100, Lake St Louis, MO 63367-1481 | 2009-06-08 |
| 1407960107 | Digestive Disease Medical Consultants, PC | Internal Medicine | 200 Brevco Plz, Suite 208, Lake St Louis, MO 63367-2949 | 2006-08-18 |
| 1730101874 | Joseph Franklin Rodemann | Internal Medicine | 300 Medical Plz Ste 310, Lake St Louis, MO 63367-1484 | 2006-07-25 |
| 1437110681 | Qaiser Jawaid | Internal Medicine | 300 Medical Plz, Suite 100, Lake St Louis, MO 63367-1481 | 2006-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316589708 | Gastroenterology of The Four States,llc | Internal Medicine | 2024 S Maiden Ln Ste 204, Joplin, MO 64804-0319 | 2019-10-17 |
| 1013414317 | Digestive Consultants LLC | Internal Medicine | 222 S Woods Mill Rd Ste 410, Chesterfield, MO 63017 | 2018-04-12 |
| 1184038788 | Prianka Radhika Chilukuri | Internal Medicine | 3635 Vista Avenue, Fdt 9 South, St. Louis, MO 63110 | 2014-06-12 |
| 1871911149 | Sean Doran | Internal Medicine | 2521 Glenn Hendren Dr Ste 408, Liberty, MO 64068-3388 | 2014-04-02 |
| 1215359484 | Advanced Gastroenterology & Colon Cancer Screening Center LLC | Internal Medicine | 763 S New Ballas Rd # 265, Saint Louis, MO 63141-8704 | 2014-01-07 |
| 1689014276 | Antonio Ricardo Cheesman Rocca | Internal Medicine | 1225 S Grand Blvd Fl 3, Saint Louis, MO 63104-1016 | 2013-06-27 |
| 1578805610 | Paul Edmond St. Romain | Internal Medicine | 2115 S Fremont Ave Ste 3300, Springfield, MO 65804-2246 | 2013-03-26 |
| 1114285947 | Samuel Wieland Schowengerdt | Internal Medicine | 5330 N Oak Trfy Ste 102, Kansas City, MO 64118 | 2012-04-30 |
| 1720346729 | Kayci Renee Huff-hardy | Internal Medicine | 621 S New Ballas Rd Ste 437a, Saint Louis, MO 63141-8259 | 2012-04-26 |
| 1649542713 | Robert Earl Stufflebam | Internal Medicine | 3895 E Pond Apple Dr, Springfield, MO 65809-3752 | 2012-02-03 |
| Find all providers with the same taxonomy | ||||
| City | LAKE ST LOUIS |
| Zip Code | 63367 |
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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.