STEVE LEROY PETERSON (NPI# 1306849500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306849500 |
| Entity Type | Individual |
| Full Name | STEVE LEROY PETERSON |
| Credential | M.D. |
| Practice Address |
1009 North State of Franklin Access Road Johnson City TN 37604 |
| Practice Telephone | 4239297546 |
| Practice Fax Number | 4239297968 |
| Mailing Telephone | 4239297546 |
| Mailing Fax Number | 4239297968 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2014-11-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
39354 | TN | Allopathic & Osteopathic Physicians |
| N | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
39354 | TN | Allopathic & Osteopathic Physicians |
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
39354 | TN | Allopathic & Osteopathic Physicians |
| Street Address |
1009 NORTH STATE OF FRANKLIN ACCESS ROAD |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861495012 | Robert John Clemons | Dermatology | 1009 North State of Franklin Access Road, Johnson City, TN 37604 | 2005-05-23 |
| 1104829308 | Donald Eugene Clemons | Dermatology | 1009 North State of Franklin Access Road, Johnson City, TN 37604-3693 | 2005-05-23 |
| 1982607180 | Paul Michael Benson | Dermatology | 1009 North State of Franklin Access Road, Johnson City, TN 37604 | 2005-05-23 |
| 1881697076 | Melissa Kaye Taylor | Physician Assistant | 1009 North State of Franklin Access Road, Johnson City, TN 37604 | 2005-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560707 | Brant Logan Nickens | Physical Therapist | 809 Lamont St and Veterans Way, Johnson City, TN 37604 | 2020-08-26 |
| 1952911562 | David Sandlin Hobbs | Pharmacist | Lamont St &, Veterans Way, Johnson City, Tn 37604, Johnson City, TN 37604 | 2020-08-07 |
| 1528688272 | Whitney Marie Ward | Physical Therapist | Lamont Street and Veterans Way, Johnson City, TN 37604 | 2020-04-23 |
| 1861050015 | Akesh Thomas | Student in an Organized Health Care Education/Training Program | Johnson City Medical Center, 400 N State of Franklin Rd, Johnson City, TN 37604 | 2019-06-03 |
| 1336629021 | Medical Education Assistance Corporation | Clinic/Center | 820 W Market St, Johnson City, TN 37604 | 2018-08-21 |
| 1093208951 | Lauren Tiffany Hayden | Physician Assistant | 403 N State of Franklin Rd Woodridge Hospital, Johnson City, TN 37604 | 2018-06-14 |
| 1174014450 | Jerica Moore | Specialist/Technologist | 1041 Hamiltion Place Dr., Johnson City, TN 37604 | 2018-05-23 |
| 1053809442 | Syed Ghazanfar Hasan | Student in an Organized Health Care Education/Training Program | Etsu Psychiatry and Behavioral Sciences Department, 1276 Gilbreath Dr., Johnson City, TN 37604 | 2018-05-01 |
| 1699262485 | Sonia Kumari Oad | Student in an Organized Health Care Education/Training Program | 178 West Maple St, Johnson City, TN 37604 | 2018-04-17 |
| 1821519364 | Mahmoud El Iskandarani | Internal Medicine | 1084 W Oakland Avenue, 748, Johnson City, TN 37604 | 2017-07-06 |
| Find all providers in zip 37604 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235230707 | Kenneth Hugh Mccarley | Otolaryngology | 2414 Chambliss Ave Nw, Cleveland, TN 37311-3879 | 2006-09-26 |
| 1144330606 | Jack P. Byrd | Otolaryngology | 2414 Chambliss Ave N.w., Cleveland, TN 37311 | 2006-08-30 |
| 1871601286 | Timothy Allen Viser | Otolaryngology | 2414 Chambliss Avenue, Cleveland, TN 37320-5030 | 2006-08-26 |
| 1689654014 | Larry Creston Young | Otolaryngology | 345 23rd Ave North, Suite 412, Nashville, TN 37203 | 2006-01-20 |
| 1427030782 | Frank G Rao | Otolaryngology | 1383 S College St, Winchester, TN 37398-2414 | 2005-11-14 |
| 1801243118 | Joseph Derbyshire | Otolaryngology | 401 S Gallaher View Rd, Apt 10, Knoxville, TN 37919-5308 | 2016-05-17 |
| 1407190853 | David A Gilpin Md Plc | Otolaryngology | 397 Wallace Rd, Suite 101, Nashville, TN 37211-4854 | 2012-11-23 |
| 1750570974 | Head & Neck Specialties, PC | Otolaryngology | 1755 Gunbarrel Rd, Suite 301, Chattanooga, TN 37421-7137 | 2007-10-24 |
| 1255469235 | Cleveland Head & Neck Clinic | Otolaryngology | 2414 Chambliss Ave Nw, Cleveland, TN 37311-3879 | 2007-03-01 |
| 1952365355 | Thomas Werner Holzen | Otolaryngology | 393 Wallace Rd, Suite 202, Nashville, TN 37211-4880 | 2006-04-13 |
| Find all providers with the same taxonomy | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
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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.