CARL PETERS


Address: 12348 Old Tesson Rd, Suite 180, Saint Louis, MO 63128-2251
Phone: 3144672014

CARL PETERS (NPI# 1053403915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1053403915
Entity Type Individual
Full Name CARL PETERS
Credential MD
Practice Address 12348 Old Tesson Rd
Suite 180
Saint Louis
MO 63128-2251
Practice Telephone 3144672014
Practice Fax Number 3144672170
Mailing Telephone 3144672014
Mailing Fax Number 3144672170
Enumeration Date 2006-09-29
Last Update Date 2014-09-09
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine 2009012802 MO Allopathic & Osteopathic Physicians
N 207Q00000X Family Medicine 036099983 IL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IL 036099983 05
MO 205521800 05

Other Providers CARL PETERS

NPI Name Taxonomy Address Enumeration
1265456982 Carl Wade Peters Jr. Dermatology 2301 N 9th Ave, Suite 200, Pensacola, FL 32503-3950 2006-07-26
1063458636 Carl Edwin Peters Physician Assistant 1551 Indian Hills Dr, Sioux City, IA 51104-1859 2006-06-21
1275554883 Carl William Peters Anesthesiology 1600 Sw Archer Road, Gainesville, FL 32610-0254 2006-07-21

Office Location

Street Address 12348 OLD TESSON RD
SUITE 180
City SAINT LOUIS
State MO
Zip Code 63128-2251

Providers in the same location

NPI Name Taxonomy Address Enumeration
1548251929 Mercy Health Services, LLC Pharmacy 12348 Old Tesson Rd, Suite 100, Saint Louis, MO 63128-2215 2005-11-03
1447629464 Irene Rathjen Nurse Practitioner 12348 Old Tesson Rd, Ste 160, Saint Louis, MO 63128-2251 2015-09-21
1831432814 Jennifer Lynn Tietjen Nurse Practitioner 12348 Old Tesson Rd, St 160, Saint Louis, MO 63128-2251 2013-03-28
1891049979 Regeneration Orthopedics, LLC Anesthesiology 12348 Old Tesson Rd, Ste120, Saint Louis, MO 63128-2251 2012-10-29
1831489566 Jennifer Marshall Chung Internal Medicine 12348 Old Tesson Rd, Suite 250, Saint Louis, MO 63128-2251 2011-04-14
1578867164 Emily Joy Riley Nurse Practitioner 12348 Old Tesson Rd, Suite 160, Saint Louis, MO 63128-2251 2010-12-22
1700067352 Ann M Schulte Nurse Practitioner 12348 Old Tesson Rd, Suite 160, Saint Louis, MO 63128-2251 2007-11-23
1851588800 Michael Pineda Gerardo Internal Medicine 12348 Old Tesson Rd, Suite 250, Saint Louis, MO 63128-2251 2007-10-03
1699898312 Amy Susan Beck Internal Medicine 12348 Old Tesson Rd, Suite 240, Saint Louis, MO 63128-2251 2007-04-09
1497854533 Smith Surgical Services, LLC Surgery 12348 Old Tesson Rd, Suite 180, Saint Louis, MO 63128-2215 2006-09-22
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1235771155 James T Fetsch Dmd LLC Dentist 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 2019-10-11
1326504655 Nikodem Dental Holdings Dentist 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 2019-02-12
1932678505 Michelle Anne Arvidson Physical Therapy Assistant Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 2018-11-13
1245726710 Kristen Rider Nurse Practitioner 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 2018-07-07
1306217427 Sophia Bednarski Dentist 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 2015-10-15
1427434224 Darcie Burrus Counselor 12523 Old Tesson Rd G, St Louis, MO 63128 2015-08-04
1710368584 Sara Hawatmeh Internal Medicine 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 2015-06-17
1871989590 Celia Grace Montes-kolence Speech-Language Pathologist 12335 W Bend Drive, Saint Louis, MO 63128 2015-04-09
1245629302 Marius Antonio Evans Dentist 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 2015-01-13
1801230313 Sarah Elizabeth Walsh Emergency Medicine 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 2013-04-26
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, 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 Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1356986541 Pain Relief Center of St Louis LLC Family Medicine 1115 Olivette Executive Pkwy, Saint Louis, MO 63132-3259 2019-11-12
1720635329 Mercy Clinic East Communities Family Medicine 10004 Kennerly Rd Ste 395b, Saint Louis, MO 63128-2190 2019-08-20
1063066777 Isabella Citizens for Health, Inc. Family Medicine 312 Union St, Saint Louis, MI 48880-1830 2019-07-31
1043864010 Isabella Citizens for Health, Inc. Family Medicine 113 E Saginaw St, Saint Louis, MI 48880-1755 2019-07-29
1558896969 Shivani Sockanathan Family Medicine 969 N Mason Rd Ste 145a, Saint Louis, MO 63141-6282 2017-04-23
1598299646 Kharole Compere Family Medicine 175 N Oaks Plz, Saint Louis, MO 63121-2925 2017-04-16
1396109880 Ritesh Gandhi Family Medicine 7345 Watson Rd Ste 203, Saint Louis, MO 63119 2016-04-11
1144608035 Daniel Urcuyo Family Medicine 4625 Lindell Blvd Ste 338, Saint Louis, MO 63108 2015-05-11
1376958728 Jamil Neme Family Medicine 3660 Vista Ave Ste 103, Saint Louis, MO 63110-2540 2014-06-24
1144633819 Perini Shah Family Medicine 12700 Southfork Rd Ste 215, Saint Louis, MO 63128-3276 2014-06-10
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Competitor

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City SAINT LOUIS
Zip Code 63128

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Dataset Information

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.

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