James Lee Petersen (NPI# 1467672774, PAC ID# 7810067238) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1467672774 |
| PAC ID by PECOS | 7810067238 |
| Professional Enrollment ID | I20190619002540 |
| Full Name | James Lee Petersen |
| Organization Legal Name | CARE UNITED MEDICAL CENTER OF LARAMIE, LLC |
| Address |
3810 E Grand Ave Laramie WY 82070-5179 |
| Phone Number | 3077211794 |
| Gender | M |
| Graduation Year | 2015 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 7719168491 |
| Number of Group Practice Members | 12 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 280061 | REGIONAL WEST MEDICAL CENTER |
| 060010 | POUDRE VALLEY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 3810 E Grand Ave, Laramie, WY 82070-5179 | 3077211794 | CARE UNITED MEDICAL CENTER OF LARAMIE, LLC |
| Organization Legal Name | CARE UNITED MEDICAL CENTER OF LARAMIE, LLC |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Courtney N Gordon | Physician Assistant | Care United Medical Center of Laramie, LLC | 3810 E Grand Ave, Laramie, WY 82070-5179 |
| Daniel E Surdam | Emergency Medicine | Care United Medical Center of Laramie, LLC | 1919 Central Ave, Cheyenne, WY 82001-3742 |
| Joslyn Thompson | Nurse Practitioner | Care United Medical Center of Laramie, LLC | 1919 Central Ave, Cheyenne, WY 82001-3742 |
| Amy R Surdam | Nurse Practitioner | Care United Medical Center of Laramie, LLC | 1919 Central Ave, Cheyenne, WY 82001-3742 |
| Katherine J Sanne | Nurse Practitioner | Care United Medical Center of Laramie, LLC | 1919 Central Ave, Cheyenne, WY 82001-3742 |
| Michael Sprosty | Physician Assistant | Care United Medical Center of Laramie, LLC | 1919 Central Ave, Cheyenne, WY 82001-3742 |
| Shawn Rockey | Physician Assistant | Care United Medical Center of Laramie, LLC | 3810 E Grand Ave, Laramie, WY 82070-5179 |
| Jennifer A Martin | Nurse Practitioner | Care United Medical Center of Laramie, LLC | 1919 Central Ave, Cheyenne, WY 82001-3742 |
| William T Carter Iii | Nurse Practitioner | Care United Medical Center of Laramie, LLC | 1919 Central Ave, Cheyenne, WY 82001-3742 |
| Herlly Yohanna Camacho | Nurse Practitioner | Care United Medical Center of Laramie, LLC | 1919 Central Ave, Cheyenne, WY 82001-3742 |
| Street Address |
3810 E GRAND AVE |
| City | LARAMIE |
| State | WY |
| Zip | 82070-5179 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Courtney N Gordon | Physician Assistant | Care United Medical Center of Laramie, LLC | 3810 E Grand Ave, Laramie, WY 82070-5179 |
| Shawn Rockey | Physician Assistant | Care United Medical Center of Laramie, LLC | 3810 E Grand Ave, Laramie, WY 82070-5179 |
| Jonathan Jones | Physician Assistant | Care United Medical Center of Laramie, LLC | 3810 E Grand Ave, Laramie, WY 82070-5179 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Charles M Cupps | Chiropractic | 212 E Ivinson, Laramie, WY 82070-3039 | |
| Brent L Bondurant | Chiropractic | 212 E Ivinson Ave, Laramie, WY 82070-3039 | |
| Denise A Gill | Clinical Social Worker | 107 S 5th St, Laramie, WY 82070-3123 | |
| Shontay M Roe | Clinical Social Worker | 112 S 5th St, Laramie, WY 82070-3124 | |
| Charles W Denison | Psychologist, Clinical | 121 E Grand Ave, Suite 202, Laramie, WY 82070-3600 | |
| Larae Sue Stibitz | Clinical Social Worker | 121 E Grand Ave, Suite 216, Laramie, WY 82070-3600 | |
| Janet L Somlyay | Nurse Practitioner | 311 S 2nd St, Laramie, WY 82070-3611 | |
| Julia A Duncan | Nurse Practitioner | 502 S 4th St, Laramie, WY 82070-3704 | |
| Leah S White | Nurse Practitioner | 504 S 4th St, Laramie, WY 82070-3704 | |
| Teresa Jacobs Castano | Clinical Social Worker | 502 S 4th St, Laramie, WY 82070-3704 | |
| Find all physicians in zip 82070 | |||
| City | LARAMIE |
| Zip Code | 82070 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | LARAMIE + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.