SEAN DARRELL PETERSON (NPI# 1497142582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497142582 |
| Entity Type | Individual |
| Full Name | SEAN DARRELL PETERSON |
| Credential | MD |
| Practice Address |
13953 S Bangerter Pkwy Draper UT 84020-5429 |
| Mailing Address |
1250 E 3900 S Suite 260 Salt Lake City UT 84124-1348 |
| Practice Telephone | 3859004090 |
| Practice Fax Number | 8013651033 |
| Mailing Telephone | 8012652000 |
| Mailing Fax Number | 8012652008 |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2018-05-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 9853800-1205 | UT | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710524970 | Sean Wiberg Peterson | Specialist/Technologist | 1810 Catlin Ave, Room 1246, Superior, WI 54880 | 2019-12-06 |
| 1619362001 | Sean Luke Peterson | Surgery | 9 W Franklin Ave Apt 306, Minneapolis, MN 55404-2594 | 2015-04-02 |
| 1922619121 | Sean Peterson | Behavior Technician | 1001 Sneath Ln Ste 200, San Bruno, CA 94066-2349 | 2020-08-11 |
| 1235571266 | Sean Patrick Peterson | Behavioral Analyst | 444 S 44th St, Omaha, NE 68131-3727 | 2013-07-18 |
| 1104899467 | Sean G Peterson | Occupational Therapist | 700 West Avenue South, La Crosse, WI 54601 | 2006-02-08 |
| Street Address |
13953 S BANGERTER PKWY |
| City | DRAPER |
| State | UT |
| Zip Code | 84020-5429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932428232 | Joseph Sterling Atkin | Family Medicine | 13953 S Bangerter Pkwy, Draper, UT 84020-5429 | 2010-05-26 |
| 1700397627 | Angela Marie White | Physician Assistant | 13953 S Bangerter Pkwy, Draper, UT 84020-5429 | 2017-10-18 |
| 1285151662 | Angela Marie Banz | Physician Assistant | 13953 S Bangerter Pkwy, Draper, UT 84020-5429 | 2017-08-25 |
| 1093179160 | Jessica Wilkinson | Family Medicine | 13953 S Bangerter Pkwy, Draper, UT 84020-5429 | 2016-04-05 |
| 1821465469 | Utah Gastroenterology P C | Internal Medicine | 13953 S Bangerter Pkwy, Draper, UT 84020 | 2015-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194322776 | Chase Larsen Dmd Pllc | Dentist | 723 E 12200 S, Draper, UT 84020 | 2020-10-06 |
| 1780222380 | Derek Cragun | Counselor | 11706 700 E, Draper, UT 84020 | 2019-12-13 |
| 1720629371 | Own My Health Medical | Clinic/Center | 12371 900 E, Suite 102, Draper, UT 84020 | 2019-10-04 |
| 1508418856 | Thomas Mifflin | Physician Assistant | 721 East 12200 South, Draper, UT 84020 | 2019-07-16 |
| 1124670872 | Necia Dalley | Registered Nurse | 11800 S State St, Draper, UT 84020 | 2019-07-12 |
| 1285100784 | Tracey M Williams | Psychologist | 13200 S 1601 E, Draper, UT 84020 | 2018-10-23 |
| 1275008328 | Amoni Paeahelotu Finau | Community Health Worker | 13703 Wheatfield Way, Draper, UT 84020 | 2018-10-04 |
| 1891275525 | Cynthia Mae Bolton | Psychologist | 1192 E Draper Parkway # 447, Draper, UT 84020 | 2018-08-21 |
| 1164908026 | Headin' Home Inc. | Community/Behavioral Health | 12300 S. 150 W., Draper, UT 84020 | 2018-07-13 |
| 1366932576 | Forest Hulet | Dentist | 219 E 12300, Ste I-5, Draper, UT 84020 | 2018-05-14 |
| Find all providers in zip 84020 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235526088 | Lone Peak Medical Associates Pllc | Family Medicine | 14768 S Dryburg Cv, Draper, UT 84020-5673 | 2015-04-20 |
| 1477817443 | Betsy Reese | Family Medicine | 74 E Kimballs Ln Ste 260, Draper, UT 84020-5009 | 2012-06-25 |
| 1932428232 | Joseph Sterling Atkin | Family Medicine | 13953 S Bangerter Pkwy, Draper, UT 84020-5429 | 2010-05-26 |
| 1841430733 | Susan E Prater | Family Medicine | 11724 South State St, Ste 100, Draper, UT 84020-7165 | 2009-03-04 |
| 1689893174 | Draper Family Medical Associates, LLC | Family Medicine | 12272 South 800 East, Suite A, Draper, UT 84020 | 2007-04-24 |
| 1245315332 | Layne A Hermansen | Family Medicine | 877 E 12300 S, Suite 201, Draper, UT 84020 | 2006-10-26 |
| 1750320925 | Jennifer L Swenson | Family Medicine | 12473 S Minuteman Dr, Draper, UT 84020 | 2006-06-05 |
| 1700842804 | Kennon Christopher Tubbs | Family Medicine | 13584 S Carolina Hill Ct, Draper, UT 84020-7726 | 2006-04-26 |
| 1922070093 | Matthew Todd Andersen | Family Medicine | 11760 S 700 E, Ste 111, Draper, UT 84020-6604 | 2006-02-03 |
| 1114910072 | Harold N Gooch | Family Medicine | 12176 South 1000 East, Draper, UT 84020 | 2005-08-25 |
| Find all providers in DRAPER | ||||
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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.