TIA PETERSON (NPI# 1902277908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902277908 |
| Entity Type | Individual |
| Full Name | TIA PETERSON |
| Credential | NP-C |
| Practice Address |
24 S 1100 E #201 Salt Lake City UT 84102-1500 |
| Practice Telephone | 3852901289 |
| Mailing Telephone | 3852901289 |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2016-05-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
324961-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
24 S 1100 E #201 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84102-1500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801888748 | Thomas R Calame | Internal Medicine | 24 S 1100 E, Ste 105, Salt Lake City, UT 84102-1500 | 2005-08-17 |
| 1205222627 | Brittney Balogh, Md, PC | Surgery | 24 S 1100 E, Suite 302, Salt Lake City, UT 84102-1500 | 2015-04-13 |
| 1215325576 | Daniel Camp | Physician Assistant | 24 S 1100 E, Suite 101, Salt Lake City, UT 84102-1500 | 2015-01-08 |
| 1649681065 | Margy Batson LLC | Clinic/Center | 24 S 1100 E, Suite 209, Salt Lake City, UT 84102-1500 | 2014-05-20 |
| 1821421983 | Eric C. Chenworth, D.o.,p.c. | Allergy & Immunology | 24 S 1100 E, Suite 201, Salt Lake City, UT 84102-1500 | 2013-08-13 |
| 1699010769 | Joanne Sumpio Hinson Md Pllc | Obstetrics & Gynecology | 24 S 1100 E, Ste 210, Salt Lake City, UT 84102-1500 | 2012-11-30 |
| 1376887927 | Eric C Chenworth D O P C | Clinic/Center | 24 S 1100 E, Suite 201, Salt Lake City, UT 84102-1500 | 2012-11-20 |
| 1710262860 | Patricia Jean Romney Church | Physician Assistant | 24 S 1100 E, Suite 101, Salt Lake City, UT 84102-1500 | 2011-10-19 |
| 1861776494 | Jordan Robert Mcqueen | Physician Assistant | 24 S 1100 E, Suite 101, Salt Lake City, UT 84102-1500 | 2011-09-30 |
| 1184902801 | Wasatch Physical Therapy and Rehabilitation, Inc | Physical Therapist | 24 S 1100 E, #105, Salt Lake City, UT 84102-1500 | 2011-07-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942818604 | Wendy Vazquez | Behavior Technician | 515 S 700 E Suit 2a, Salt Lake City, UT 84102 | 2020-07-20 |
| 1407481245 | Odyssey House Inc | Family Medicine | 743 E 300 S, Salt Lake City, UT 84102 | 2020-03-11 |
| 1093359960 | Hayle Mayer | Behavior Technician | 515 S 700 E Salt Lake City, Suite 2a, Salt Lake, UT 84102 | 2019-11-04 |
| 1326680869 | Ronald Mcdonald House of The Intermountain Area | Meals | 935 E. South Temple, Salt Lake City, UT 84102 | 2019-10-16 |
| 1508419581 | Claire Pemberton | Behavior Technician | 327 E 1300 S, Apt 2, Salt Lake City, UT 84102 | 2019-07-19 |
| 1558923144 | Olivia Anne Hardwick | Social Worker | Transitions At Slrmc, 86 S. 1100 E. Suite 404, Salt Lake City, UT 84102 | 2019-07-03 |
| 1649741802 | Colten Vancampen | Behavior Technician | 515 S 700 E #2a, Salt Lake City, UT 84102 | 2018-12-16 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1104311661 | Malorey Kooyman | Behavior Technician | 515 700 East, Suite 2a, Salt Lake City, UT 84102 | 2018-06-27 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
| Find all providers in zip 84102 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204590 | Gabrielle Sleater Lewis | Nurse Practitioner | 2905 S Mcclelland St, Salt Lake City, UT 84106-2125 | 2020-11-01 |
| 1962019596 | Freya Kristen Landesman | Nurse Practitioner | 60 E South Temple Ste 300, Salt Lake City, UT 84111-1041 | 2020-09-28 |
| 1568075604 | Michelle L Davis | Nurse Practitioner | 24 S 1100 E Ste 305, Salt Lake City, UT 84102-4500 | 2020-08-28 |
| 1518583988 | Melanie Elise Harris | Nurse Practitioner | 1250 E 3900 S Ste 301, Salt Lake City, UT 84124-1350 | 2020-06-22 |
| 1295359651 | Julie Nielsen | Nurse Practitioner | 1170 E Westminster Ave Apt C, Salt Lake City, UT 84105-3514 | 2020-06-02 |
| 1770112138 | Justin Henderson | Nurse Practitioner | 3851 S Birch Dr, Salt Lake City, UT 84109-3742 | 2020-04-07 |
| 1346885845 | Anita Hui Lucente | Nurse Practitioner | 1111 E Brickyard Rd, Salt Lake City, UT 84106-2560 | 2019-11-08 |
| 1841844057 | Mayra Ibeth Vences | Nurse Practitioner | 1146 N Antilles Dr, Salt Lake City, UT 84116-4656 | 2019-07-25 |
| 1710549928 | Jenny Farley Mason | Nurse Practitioner | 4179 S Monarch Way, Salt Lake City, UT 84124-3168 | 2019-07-08 |
| 1144889940 | Amy Jackson Gilbert | Nurse Practitioner | 1950 Circle of Hope Dr Rm 4146, Salt Lake City, UT 84112-5500 | 2019-06-06 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84102 |
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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.