DR. PAMELA CAROL PETERSEN (NPI# 1285999185) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285999185 |
| Entity Type | Individual |
| Full Name | DR. PAMELA CAROL PETERSEN |
| Credential | M.D. |
| Practice Address |
6651 Main St Houston TX 77030 |
| Mailing Address |
6651 Main St Houston TX 77030-2351 |
| Practice Telephone | 8328264431 |
| Mailing Telephone | 8328264431 |
| Enumeration Date | 2012-07-07 |
| Last Update Date | 2018-11-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 63560-20 | WI | Allopathic & Osteopathic Physicians |
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
R7563 | TX | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9000 W Wisconsin Ave, Chw Clinics Bldg Ste 550, Milwaukee, WI 532264874 | 4142663392 | 4142664185 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932267523 | Pamela R Petersen | Specialist | 11931 4050 Rd, Paonia, CO 81428-6418 | 2006-12-05 |
| 1639514227 | Pamela Kay Petersen | Registered Nurse | 601 East St, Pahrump, NV 89048-5368 | 2013-05-08 |
| 1548326317 | Pamela H Petersen | Midwife | 10 Benton Avenue, Middletown, NY 10940 | 2006-12-28 |
| 1255430716 | Pamela O Petersen | Pediatrics | 2330 W Covell Blvd, Davis, CA 95616-5658 | 2006-09-21 |
| Street Address |
6651 MAIN ST |
| City | HOUSTON |
| State | TX |
| Zip Code | 77030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184618753 | Michael A Belfort | Obstetrics & Gynecology | 6651 Main St, Suite 420, Houston, TX 77030-2351 | 2005-09-09 |
| 1376140756 | Sandisiwe Ndlovu | Nurse Practitioner | 6651 Main St, Houston, TX 77030-2351 | 2020-10-08 |
| 1649887340 | Rasheedat Romoke Adewumi | Registered Nurse | 6651 Main St, Houston, TX 77030-2351 | 2020-09-26 |
| 1427669753 | Jeffrey Richard Vanliew | Pharmacist | 6651 Main St, Houston, TX 77030-2351 | 2020-08-11 |
| 1558971374 | Norma Isabel Castillo | Registered Nurse | 6651 Main St, Houston, TX 77030-2351 | 2020-08-06 |
| 1881214781 | Sarah Bostick | Registered Nurse | 6651 Main St, Houston, TX 77030-2351 | 2020-04-21 |
| 1790311348 | Natasha N Bhayani | Nurse Practitioner | 6651 Main St, Houston, TX 77030-2351 | 2020-03-16 |
| 1003458340 | Alyson Rose Beck | Physical Therapist | 6651 Main St, Houston, TX 77030-2351 | 2019-10-08 |
| 1619528916 | Emily Clifton | Registered Nurse | 6651 Main St, Houston, TX 77030-2351 | 2019-09-27 |
| 1053969378 | Simone Romero | Physical Therapist | 6651 Main St, Houston, TX 77030-2351 | 2019-08-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770852 | Mchaji Celestaine | Pharmacist | Medvamc 2002 Holcombe Blvd, Outpatient Pharmacy, Houston, TX 77030 | 2020-11-04 |
| 1730702598 | Christopher A Mcmillian | Student in an Organized Health Care Education/Training Program | Houston Methodist Department of Surgery, 6550 Fannin St., Smith Tower 1661, Houston, TX 77030 | 2020-05-27 |
| 1245852698 | Mostafa Hotait | Student in an Organized Health Care Education/Training Program | 7200 Cambridge Street 9a, Houston, TX 77030 | 2020-05-08 |
| 1790307288 | Ayushi Jayesh Shah | Student in an Organized Health Care Education/Training Program | 6560 Fannin St, Department of Neurology, Houston Method, Suite 802, Scurlock. 8thfloor, Houston, TX 77030 | 2020-05-07 |
| 1932720836 | Vera Whole Health Wa, PC | Clinic/Center | 6620 Main St, 12th Flr, Ste 1225, Houston, TX 77030 | 2020-05-01 |
| 1548881808 | Mobitz Heart and Rhythm Center Pllc | Internal Medicine | Scurlock Tower, 6560 Fannin St., Houston, TX 77030 | 2020-04-28 |
| 1710516513 | Thomas Chi Han Lu | Student in an Organized Health Care Education/Training Program | 6431 Fannin Street, Msb 3.151, Houston, TX 77030 | 2020-04-03 |
| 1063041085 | Kevin Tang | Student in an Organized Health Care Education/Training Program | 7200 Cambridge., Bcm 903, Suite A10.202, Houston, Texas, TX 77030 | 2020-04-02 |
| 1831728898 | Taylor Renbarger | Student in an Organized Health Care Education/Training Program | 6431 Fannin St Suite Jjl 431, Houston, TX 77030 | 2020-04-02 |
| 1972131423 | Sindhu R Rao | Student in an Organized Health Care Education/Training Program | 7200 Cambridge Street, 9th Floor, Suite 9a, Houston, TX 77030 | 2020-03-31 |
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| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053730226 | Jaime Conrado Silva | Pediatrics | 1911 Holcombe Blvd Apt 1326, Houston, TX 77030-4189 | 2014-04-15 |
| 1144574591 | Amy Sharon Arrington | Pediatrics | 6621 Fannin, W6006, Houston, TX 77030 | 2012-11-07 |
| 1306118013 | Corey Chartan | Pediatrics | One Baylor Plaza, Mail Stop W6-006, Pediatric Critical Care, Houston, TX 77070 | 2012-01-27 |
| 1396971206 | Kevin Matthew Roy | Pediatrics | 6621 Fannin Street, Wt6-006, Texas Children's Hospital, Pediatrics Intensive Care, Houston, TX 77030 | 2009-06-05 |
| 1396911715 | Aarti C Bavare | Pediatrics | 6621 Fannin, Wt6-006, Houston, TX 77030 | 2008-05-06 |
| 1225106875 | Childrens Critical Care of San Antonio Pa | Pediatrics | 5925 Kirby Dr, E354, Houston, TX 77005-2546 | 2006-12-01 |
| 1841803756 | Bethany Wright Moura | Pediatrics | 6410 Fannin St, Houston, TX 77030-3000 | 2020-08-29 |
| 1912569054 | Sheila Carballo Sy | Pediatrics | 6431 Fannin Street, Msb 5.232, Houston, TX 77003 | 2019-06-28 |
| 1255894846 | Tammy L Eckhardt | Pediatrics | 6701 Fannin St, Houston, TX 77030-2608 | 2019-04-10 |
| 1568953610 | Morgan Rockwell | Pediatrics | 6621 Fannin St, Houston, TX 77030 | 2018-05-24 |
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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.