DR. THOMAS G PETERSON (NPI# 1114043387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114043387 |
| Entity Type | Individual |
| Full Name | DR. THOMAS G PETERSON |
| Credential | O.D. |
| Practice Address |
150a County Road B Shawano WI 54166 |
| Mailing Address |
150a County Road B Shawano WI 54166-7072 |
| Practice Telephone | 7155263163 |
| Practice Fax Number | 7155264019 |
| Mailing Telephone | 7155263163 |
| Mailing Fax Number | 7155264019 |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2018-07-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2324 | WI | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 38578000 | 05 | |
| WI | RAILROAD MEDICARE | 410033786 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164983086 | Thomas Rex Peterson | Emergency Medicine | Fau Emergency Medicine, Bethesda Hospital East, Attn: Joanne Daly, 2815 S. Seacrest Blvd., Boynton Beach, FL 33435 | 2019-03-26 |
| 1992208227 | Thomas Joseph Peterson | Student in an Organized Health Care Education/Training Program | Anesthesiology Residency Program, Wrnmmc, 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2018-03-13 |
| 1275758187 | Thomas Mckeel Peterson | Dentist | 318 3rd Ave Nw, Hickory, NC 28601 | 2007-04-16 |
| 1093841397 | Thomas David Peterson | Neuromusculoskeletal Medicine & OMM | 1178 Charnelton St, Eugene, OR 97401-3431 | 2007-02-23 |
| 1851492573 | Thomas John Peterson | Dentist | 519 Christel Dr., Valders, WI 54245 | 2006-09-26 |
| 1891806709 | Thomas Merlin Peterson | Dentist | 816 W St Germain St #101, St Cloud, MN 56301-3511 | 2006-08-31 |
| 1891755823 | Thomas Michael Peterson | Specialist/Technologist | 3537 10th St S, Fargo, ND 58104-6201 | 2006-03-24 |
| 1205492287 | Thomas Adam Peterson | Occupational Therapy Assistant | 8820 Horizon Blvd Ne, Albuquerque, NM 87113-1689 | 2019-05-14 |
| 1659849149 | Thomas Peterson | Behavior Technician | 101 H St Ste L, Petaluma, CA 94952-5100 | 2018-11-02 |
| 1699267609 | Thomas Austin Peterson | Student in an Organized Health Care Education/Training Program | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2018-06-05 |
| Street Address |
150A COUNTY ROAD B |
| City | SHAWANO |
| State | WI |
| Zip Code | 54166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134641848 | Nicole Jeannine Klotzbuecher | Optometrist | 150 County Road B, Shawano, WI 54166 | 2017-07-13 |
| 1437605714 | Jennifer Marie Franke | Counselor | 504 Lakeland St, Shawano, WI 54166 | 2016-08-28 |
| 1699017913 | Benjamin D Schlais | Family Medicine | 100 County Hwy B, Shawano, WI 54166 | 2013-03-25 |
| 1154574366 | Luke T Johnson | Speech-Language Pathologist | N3684 River Road, Shawano, WI 54166 | 2008-10-31 |
| 1902054315 | Robert Joseph Bohr Jr. | Physical Therapy Assistant | N6590 Fox Lane, Shawano, WI 54166 | 2008-08-28 |
| 1790945863 | Patricia Rae Ainsworth | Physical Therapist | 1436 South Lincoln Street, Shawano, WI 54166 | 2008-06-12 |
| 1649491820 | Shawano-gresham School District | Local Education Agency (LEA) | 1050 South Union Street, Shawano, WI 54166 | 2007-05-02 |
| 1740343086 | John Milton Dovorany | Dentist | 1488 E Green Bay St, Shawano, WI 54166 | 2006-12-18 |
| 1265526305 | Charles E Lamarche | Counselor | 420 E Green Bay St, Ste 201, Shawano, WI 54166 | 2006-10-03 |
| 1184260358 | Kristo Ltd | Dentist | 115 Alpine Court, Shawano, WI 54166 | 2019-11-22 |
| Find all providers in zip 54166 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134641848 | Nicole Jeannine Klotzbuecher | Optometrist | 150 County Road B, Shawano, WI 54166 | 2017-07-13 |
| 1558583930 | Nhh Vision Group, S.c. | Optometrist | 301 W Green Bay St, Shawano, WI 54166-2335 | 2007-05-03 |
| 1013977347 | William James Stern | Optometrist | 153 Woodlawn Dr, Shawano, WI 54166-2233 | 2006-03-23 |
| 1932580537 | Jonathan George Menos | Optometrist | 115 Alpine Ct, Shawano, WI 54166-2048 | 2015-06-09 |
| 1447489661 | Kavit Lache Beyersdorf | Optometrist | 115 Alpine Ct, Shawano, WI 54166-0513 | 2009-07-09 |
| 1780768333 | Janson A Mancheski | Optometrist | 1244 E Green Bay St, Janson Mancheski Od, Shawano, WI 54166-2208 | 2006-10-24 |
| 1033197397 | Thomas G Peterson Od Sc | Optometrist | 115 Alpine Ct, Shawano, WI 54166-0513 | 2006-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154939288 | Myeyedr Optometry of Wisconsin, LLC | Optometrist | 2505 N Mayfair Rd Ste 100, Wauwatosa, WI 53226-1404 | 2020-07-15 |
| 1689291254 | Lynne's Moc, LLC | Optometrist | 512 State Street, Madison, WI 53703 | 2020-06-30 |
| 1891311775 | Elizabeth Carman Somers | Optometrist | 3621 Market Ln, Kenosha, WI 53144-1553 | 2020-06-17 |
| 1760008619 | Melanie Nielsen | Optometrist | S73w16437 Janesville Rd, Muskego, WI 53150-9723 | 2020-06-16 |
| 1487278479 | Alyssa Chrisman | Optometrist | 2910 Roosevelt Rd # D1, Marinette, WI 54143-5108 | 2020-06-04 |
| 1043859341 | Site 4 Eyes | Optometrist | 7245 S 76th St, Franklin, WI 53132-9041 | 2020-01-03 |
| 1932745163 | Mauston Family Eyecare, LLC | Optometrist | 205 Division St Ste A, Mauston, WI 53948-2110 | 2019-11-22 |
| 1114562345 | Dr Christopher D Smith & Associates LLC | Optometrist | 2665 Monroe Rd Ste 100, De Pere, WI 54115-9287 | 2019-11-12 |
| 1013564111 | Ayman Tabani | Optometrist | 9160 76th St Unit C, Kenosha, WI 53158-1945 | 2019-08-22 |
| 1104473537 | Espy Specs Sc | Optometrist | 2720 Golf Rd, Eau Claire, WI 54701-8011 | 2019-08-21 |
| Find all providers with the same taxonomy | ||||
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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.