DR. CHARLES SMITH PETERSON (NPI# 1952302143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952302143 |
| Entity Type | Individual |
| Full Name | DR. CHARLES SMITH PETERSON |
| Credential | M.D. |
| Practice Address |
3130 E Baseline Rd Suite 101 Mesa AZ 85204-7290 |
| Mailing Address |
8630 E Via De Ventura Ste 201 Scottsdale AZ 85258-3358 |
| Practice Telephone | 4805583744 |
| Practice Fax Number | 4805583801 |
| Mailing Telephone | 4805583744 |
| Mailing Fax Number | 4805583801 |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2019-07-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
28027 | AZ | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609026897 | Charles Marquis Peterson | Internal Medicine | 12910 Dalyn Dr, Potomac, MD 20854-1176 | 2008-09-24 |
| 1134243355 | Charles Mark Peterson | Registered Nurse | 830 14th Ave, Seattle, WA 98122-4508 | 2007-03-16 |
| 1902973415 | Charles Walter Peterson | Optometrist | 904 Elliott Ave N, Wenatchee, WA 98801-1666 | 2006-11-29 |
| 1558472613 | Charles Edwin Peterson | Internal Medicine | 904 Meadow Lane, Schenectady, NY 12309 | 2006-08-31 |
| 1700845526 | Charles A Peterson | Orthopaedic Surgery | 8438 N Mercer Way, Mercer Island, WA 98040-3134 | 2006-03-21 |
| 1871036798 | Charles Capdeville Peterson | Family Medicine | 801 S Chevy Chase Dr Ste 230, Glendale, CA 91205-4436 | 2016-11-25 |
| 1154798502 | Charles Peterson | Counselor | 185 Silas Deane Hwy, Wethersfield, CT 06109 | 2015-09-01 |
| 1982018818 | Charles William Peterson Iv | Behavioral Analyst | 21929 Highland Knolls Dr, Katy, TX 77450-5873 | 2014-06-18 |
| 1295026821 | Charles John Peterson | Student in an Organized Health Care Education/Training Program | 308 Harvard St Se, Minneapolis, MN 55455-0343 | 2011-05-01 |
| 1437234499 | Charles John Peterson | Emergency Medicine | 5301 E Grant Road, Tucson Medical Center Emergency Department, Tucson, AZ 85712-2805 | 2006-10-26 |
| Street Address |
3130 E BASELINE RD SUITE 101 |
| City | MESA |
| State | AZ |
| Zip Code | 85204-7290 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396093852 | Josie Aubrey Hunt | Physician Assistant | 3130 E Baseline Rd, Ste. 103 & 104, Mesa, AZ 85204-7290 | 2012-08-15 |
| 1831446111 | Afc Physical Medicine of Mesa, Pllc | Non-Pharmacy Dispensing Site | 3130 E Baseline Rd, Suite 107, Mesa, AZ 85204-7290 | 2012-08-06 |
| 1659645679 | Afc Physical Medicine of Mesa, Pllc | Durable Medical Equipment & Medical Supplies | 3130 E Baseline Rd, Suite 107, Mesa, AZ 85204-7290 | 2012-03-08 |
| 1295055226 | Nextcare Arizona LLC | Clinic/Center | 3130 E Baseline Rd, Ste. 105, Mesa, AZ 85204-7290 | 2010-06-01 |
| 1528392891 | Kids Dental 2 P.C. | Dentist | 3130 E Baseline Rd, #103-104, Mesa, AZ 85204-7290 | 2009-09-19 |
| 1932352598 | Emeliah Constance Hanson | Chiropractor | 3130 E Baseline Rd, Suite 107, Mesa, AZ 85204-7290 | 2008-10-28 |
| 1710915194 | Nicole Joanne Nordine | Physician Assistant | 3130 E Baseline Rd, Ste 105, Mesa, AZ 85204 | 2006-06-28 |
| 1306804539 | Morris Chiropractic Inc | Chiropractor | 3130 E Baseline Rd, Ste 107, Mesa, AZ 85204 | 2006-05-04 |
| 1770549214 | Dana Landing Urgent Care LLC | Clinic/Center | 3130 E Baseline Rd, Ste. 105, Mesa, AZ 85204-7290 | 2006-04-25 |
| 1548223225 | Ramon V Buenaver | Pediatrics | 3130 E Baseline Rd, Suite 103, Mesa, AZ 85204-7290 | 2006-04-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194374819 | Luminations Healing Center, LLC | Social Worker | 1237 S. Val Vista Dr. #221, Mesa, AZ 85204 | 2019-09-05 |
| 1881160356 | Wanjiru Landers | Student in an Organized Health Care Education/Training Program | 550 S Linda Circle, Mesa, AZ 85204 | 2018-10-22 |
| 1649754235 | Adam Desnous | Specialist/Technologist | 751 S Daley, Mesa, AZ 85204 | 2018-09-19 |
| 1982128187 | Michael Anthony Jones | Counselor | 1107 North Gilbert Rd, Mesa, AZ 85204 | 2017-07-29 |
| 1295287225 | Scottsdale Healthcare Corp | Family Medicine | 2530 W. Southern Ave, Mesa, AZ 85204 | 2016-10-25 |
| 1427504158 | Richard White | Physician Assistant | 2345 E Southern Ave # 101, Mesa, AZ 85204 | 2016-09-01 |
| 1548716780 | Pain Stop Accident Injury LLC | Chiropractor | 425 E 11th Ave, Mesa, AZ 85204 | 2016-08-28 |
| 1154704252 | Glenn Taylor Lesueur | Dentist | 1056 S. Val Vista Dr., Suite 1, Mesa, AZ 85204 | 2015-07-07 |
| 1073932513 | Naomi Devine | Nurse Practitioner | 1840 South Stapley Drive, Suite 101, Mesa, AZ 85204 | 2014-04-14 |
| 1609292531 | John Kamau | Counselor | 1060 S Lobin Ln, Mesa, AZ 85204 | 2014-03-17 |
| Find all providers in zip 85204 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| 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 Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912518044 | Nsobi Pllc | Family Medicine | 6130 E Brown Rd Ste 101, Mesa, AZ 85205-4960 | 2020-08-12 |
| 1275651507 | Alex J Onofrei Md PC | Family Medicine | 6130 E Brown Rd, Mesa, AZ 85205-4960 | 2007-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730790080 | Madison Medical Partners, LLC | Family Medicine | 911 W Las Palmaritas Dr, Phoenix, AZ 85021-5546 | 2020-08-11 |
| 1649822313 | Azmed Rehab LLC | Family Medicine | 14281 North Del Webb Blvd, Sun City, AZ 85351 | 2019-07-12 |
| 1285295089 | Modern Sports Medicine LLC | Family Medicine | 10450 E Riggs Rd Ste 104, Sun Lakes, AZ 85248-7759 | 2019-06-24 |
| 1962612069 | David G Carfagno | Family Medicine | 10133 N 92nd St, Suite 102, Scottsdale, AZ 85258-4556 | 2007-05-23 |
| 1841325552 | Donald Elwood Porter | Family Medicine | 1224 East Lowell Street, Tucson, AZ 85721 | 2007-02-22 |
| 1780732412 | Lynne Pirie | Family Medicine | 711 E Carefree Hwy Ste 208, North Phoenix Health Institute, Phoenix, AZ 85085-0109 | 2007-01-08 |
| 1174689988 | Summit Sports & Family Medicine PC | Family Medicine | 7717 W Deer Valley Rd, Suite 125, Peoria, AZ 85382-2102 | 2006-12-28 |
| 1942381611 | Thomas C Fiel Do PC | Family Medicine | 1840 E Baseline Rd # C-2, Tempe, AZ 85283-1527 | 2006-10-18 |
| 1477587335 | University Sports Medicine PC | Family Medicine | 15810 S 45th St Ste 101, Phoenix, AZ 85048-7695 | 2006-07-10 |
| 1760441174 | Robert Philip Luberto | Family Medicine | 7717 W. Deer Valley Rd., Suite 125, Peoria, AZ 85382 | 2006-03-23 |
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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.