MATHEW PETERSEN (NPI# 1427467208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427467208 |
| Entity Type | Individual |
| Full Name | MATHEW PETERSEN |
| Credential | ABOC |
| Practice Address |
409 S 8th St Boise ID 83702-7142 |
| Practice Telephone | 2083441390 |
| Practice Fax Number | 2083441391 |
| Mailing Telephone | 2083441390 |
| Mailing Fax Number | 2083441391 |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2014-08-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326445198 | Mathew James Petersen | Specialist/Technologist | 10214 Musick Rd, Saint Louis, MO 63123-5066 | 2014-11-21 |
| 1215249917 | Mathew C Petersen | Dentist | 2001 E Lohman Ave, Ste 121, Las Cruces, NM 88001-3167 | 2010-07-09 |
| Street Address |
409 S 8TH ST |
| City | BOISE |
| State | ID |
| Zip Code | 83702-7142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164960084 | Jessi Jones-paisley | Technician/Technologist | 409 S 8th St, Boise, ID 83702-7142 | 2017-02-11 |
| 1326441320 | Rose Norris | Technician/Technologist | 409 S 8th St, 101, Boise, ID 83702-7142 | 2014-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588918676 | Sue Soroor Didehban | Technician/Technologist | 7447 W Emerald St Ste 105, Boise, ID 83704-5003 | 2012-10-29 |
| 1508898065 | America's Best Contacts & Eyeglasses | Technician/Technologist | 8641 W Franklin Rd, Boise, ID 83709-0632 | 2006-07-07 |
| 1477505485 | Shopko Stores Operating Co. LLC | Technician/Technologist | 2655 Broadway Ave, Boise, ID 83706-4721 | 2006-05-17 |
| 1982656096 | Shopko Stores Operating Co. LLC | Technician/Technologist | 8105 Fairview Ave, Boise, ID 83704-8486 | 2006-05-17 |
| 1003393653 | Teri Fullmer | Technician/Technologist | 7447 W Emerald St Ste 105, Boise, ID 83704-5003 | 2018-07-26 |
| 1891290235 | Emerald Optics LLC | Technician/Technologist | 7447 W Emerald St Ste 105, Boise, ID 83704-5003 | 2018-03-27 |
| 1164960084 | Jessi Jones-paisley | Technician/Technologist | 409 S 8th St, Boise, ID 83702-7142 | 2017-02-11 |
| 1386190411 | Marnee Overduyn | Technician/Technologist | 7905 W Ustick Rd, Ste E, Boise, ID 83704-5001 | 2016-08-29 |
| 1629420526 | Brad Linder | Technician/Technologist | 409 S 8th St Ste 101, Boise, ID 83702-7136 | 2016-07-05 |
| 1306298203 | Alma Tufeckcic | Technician/Technologist | 409 S 8th St Ste 101, Boise, ID 83702-7136 | 2016-07-05 |
| Find all providers in BOISE | ||||
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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.