BLAIR SHACKLETON PETERSON


Address: 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815
Phone: 2143456000

BLAIR SHACKLETON PETERSON (NPI# 1235523721) 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) 1235523721
Entity Type Individual
Full Name BLAIR SHACKLETON PETERSON
Other Name BLAIR LEAH SHACKLETON
Credential PA-C
Practice Address 8440 Walnut Hill Ln Ste 610
Dallas
TX 75231-3815
Practice Telephone 2143456000
Practice Fax Number 2143456026
Mailing Telephone 2143456000
Mailing Fax Number 2143456026
Enumeration Date 2015-03-24
Last Update Date 2019-02-20
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant PA09776 TX Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
TX 354191401 05

Office Location

Street Address 8440 WALNUT HILL LN STE 610
City DALLAS
State TX
Zip Code 75231-3815

Providers in the same location

NPI Name Taxonomy Address Enumeration
1306846787 Byung Ryang Park Internal Medicine 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815 2005-07-28
1568913051 Elizabeth Annette Rice Nurse Practitioner 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815 2016-10-19
1295158103 Kaitlin Elizabeth Moore Physician Assistant 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815 2014-01-28
1669893848 Erin Tenney Physician Assistant 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815 2013-12-14
1689978769 Shawn Matthew Sommerlad Physician Assistant 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815 2011-01-04
1376704510 Parin Parikh Internal Medicine 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815 2008-06-20
1639294119 Charles Victor Lampe Internal Medicine 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815 2007-03-21
1124163894 Ryan Jack Martin Physician Assistant 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815 2007-02-21
1669579835 Carter A King Internal Medicine 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815 2006-09-20
1174550834 David S Harper Internal Medicine 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815 2006-06-27
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1659987022 Specialists In Geriatric and Palliative Care Medicine Pllc Clinic/Center 8198 Walnut Hill Lane, Jackson Bldg, Suite 100, Dallas, TX 75231 2020-09-21
1013546118 The Legacy Midtown Park, Inc Skilled Nursing Facility 8280 Manderville Lane, Dallas, TX 75231 2020-04-02
1003383373 Northeast Dallas Dentistry, PC Dentist 6401 East Northwest Highway, Suite 100, Dallas, TX 75231 2018-10-25
1518442565 Daniel Max & Marc Andrea LLC Optometrist 6471 E Northwest Hwy, Dallas, TX 75231 2018-09-26
1760964100 Amber Nicole Caruthers Nurse Practitioner 8060 Park Lane, Dallas, TX 75231 2018-09-01
1376024893 Brittany Leigh Stedman Physical Therapist 8130 Meadow Rd, Dallas, TX 75231 2018-08-23
1700367224 Tia Cornelius Occupational Therapy Assistant 8130 Meadow Rd., Dallas, TX 75231 2018-08-23
1538653753 Manju R. Goyal M.d. Psychiatry Pllc Psychiatry & Neurology 5477 Glen Lakes Dr Ste 210, Dallas, TX 75231 2018-06-20
1497246813 Stacy Jo Thomas Counselor 10260 N Central Expy Ste 280, Dallas, TX 75231 2018-05-21
1235626615 Texas Health Presbyterian Hospital Dallas Durable Medical Equipment & Medical Supplies 8160 Walnut Hill Lane, First Floor, Dallas, TX 75231 2018-04-20
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1932700440 Heather Weir Physician Assistant 7331 Gaston Ave Ste 180, Dallas, TX 75214-4131 2020-11-03
1225643562 Yermiahu Levi Sarne Physician Assistant 6206 Preston Crest Ln, Dallas, TX 75230-1828 2020-09-14
1255945564 Amanda Michelle Flores Physician Assistant 1801 Young St, Dallas, TX 75201 2020-09-03
1275151102 Kelly Ashworth Physician Assistant 7331 Gaston Ave # 180, Dallas, TX 75214-4131 2020-07-07
1780201715 Gabriela Yvonne Camacho Physician Assistant 7331 Gaston Ave Unit 180, Dallas, TX 75214-4131 2020-06-25
1346879699 Ws Neuroassist, Pllc Physician Assistant 7324 Gaston Ave Ste 124-80, Dallas, TX 75214-6126 2020-04-07
1265065122 Sarah Bell Stewart Physician Assistant 7811 Bryn Mawr Dr, Dallas, TX 75225-8217 2020-02-19
1093348237 Meagan Lee Barry Physician Assistant 221 W Colorado Blvd Ste 431, Dallas, TX 75208-2312 2020-02-17
1245863554 Melissa Ann Johnston Physician Assistant 4373 Boca Bay Dr, Dallas, TX 75244-7408 2020-02-14
1205479607 Mj Surgical, Pllc Physician Assistant 1408 N Riverfront Blvd # 906, Dallas, TX 75207-3912 2019-10-18
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Competitor

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City DALLAS
Zip Code 75231

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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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