DR. THEODORE THOMAS PETERS (NPI# 1922004472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922004472 |
| Entity Type | Individual |
| Full Name | DR. THEODORE THOMAS PETERS |
| Credential | M.D. |
| Practice Address |
2535 Ira E Woods Avenue Grapevine TX 76051-3930 |
| Practice Telephone | 8174812121 |
| Practice Fax Number | 8174884493 |
| Mailing Telephone | 8174812121 |
| Mailing Fax Number | 8174884493 |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2020-04-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | F4371 | TX | Allopathic & Osteopathic Physicians |
| N | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
F4371 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS BLUE SHIELD | 82X722 | 01 |
| TX | 099325501 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4501 Heritage Trace Parkway, Suite 101, Fort Worth, TX 762448940 | 8174812121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457342750 | Theodore Edward David Peters | Dentist | 508 South Habana Ave, Suite 110, Tampa, FL 33609 | 2005-11-04 |
| Street Address |
2535 IRA E WOODS AVENUE |
| City | GRAPEVINE |
| State | TX |
| Zip Code | 76051-3930 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104822659 | Christopher John Tucker | Physical Medicine & Rehabilitation | 2535 Ira E Woods Avenue, Grapevine, TX 76051-3930 | 2005-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881227346 | Jeffrey Joseph Cervenka | Physical Therapist | 2421 Ira E Woods Ave #101, Grapevine, TX 76051 | 2020-02-12 |
| 1871137562 | Karen Lorince | Counselor | 2409 N. Support Road, Grapevine, TX 76051 | 2019-11-05 |
| 1548733785 | Jessica Thorman Johnson | Dietitian, Registered | 1056 Texan Trail (fortis Bmi), Grapevine, TX 76051 | 2019-01-10 |
| 1164928958 | Kristen Diou | Counselor | 913 S Church St Ste 103, Grapevine, TX 76051 | 2018-04-02 |
| 1356860597 | Anissa Singratanakul D.m.d, Pllc | Dentist | 1231 William D Tate Suite 400, Grapevine, TX 76051 | 2017-09-19 |
| 1033637665 | James Abraham Thomas | Pharmacy | 1601 W. State Hwy 114, Grapevine, TX 76051 | 2017-09-04 |
| 1437606563 | D'anna Sims | Counselor | 2451 Stone Myers Parkway, #100, Grapevine, TX 76051 | 2016-09-07 |
| 1477006369 | Melinda Jeanne Mashburn | Nurse Practitioner | 1600 West College St., Suite 60, Grapevine, TX 76051 | 2016-07-27 |
| 1437506623 | Allcare Physicians Group | Registered Nurse | 1111 S Main St Ste 119, Grapevine, TX 76051 | 2016-05-18 |
| 1790141745 | Colwick Counseling | Clinic/Center | 1400 W. Northwest Highway Suite 260, Grapevine, TX 76051 | 2016-01-06 |
| Find all providers in zip 76051 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306914312 | Pat A Peters Md Pa | Orthopaedic Surgery | 2535 Ira E Woods, Grapevine, TX 76051-3909 | 2006-11-30 |
| 1144282526 | Scott Wenger | Orthopaedic Surgery | 815 Ira E Woods Ave, Ste 100, Grapevine, TX 76051-4009 | 2006-04-03 |
| 1972509412 | Kerry Michael Donegan | Orthopaedic Surgery | 2535 Ira E Woods Ave, Grapevine, TX 76051-3930 | 2005-06-21 |
| 1922362862 | Casey Robert Stuhlman | Orthopaedic Surgery | 2535 Ira E Woods Ave, Grapevine, TX 76051-3930 | 2012-06-26 |
| 1538450291 | Ryan Patrick Mulligan | Orthopaedic Surgery | 2535 Ira E Woods Ave, Grapevine, TX 76051-3930 | 2011-04-28 |
| 1477887313 | J. David Thompson | Orthopaedic Surgery | 2020 W State Highway 114, Suite 110, Grapevine, TX 76051-8649 | 2009-09-24 |
| 1083875827 | Michael Ryan Briseno | Orthopaedic Surgery | 2535 Ira E Woods Ave, Grapevine, TX 76051-3930 | 2008-06-24 |
| 1275720211 | Kristen Elizabeth Fleager | Orthopaedic Surgery | 2535 Ira E Woods Ave, Grapevine, TX 76051-3930 | 2007-10-03 |
| 1730204454 | Nathan Edward Williams II | Orthopaedic Surgery | 2535 Ira E Woods Ave, Grapevine, TX 76051-3930 | 2007-03-20 |
| 1093849291 | Zubin G Khubchandani Md Pa | Orthopaedic Surgery | 815 Ira E Woods Ave, Ste 100, Grapevine, TX 76051-4012 | 2007-03-16 |
| Find all providers in GRAPEVINE | ||||
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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.