SCOTT M PETERSON (NPI# 1649250242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649250242 |
| Entity Type | Individual |
| Full Name | SCOTT M PETERSON |
| Credential | MD |
| Practice Address |
3300 W Centre Ave Bronson Ob Gyn Associates Portage MI 49024-4666 |
| Mailing Address |
601 John St Box 42 Kalamazoo MI 49007-5341 |
| Practice Telephone | 2693272211 |
| Practice Fax Number | 2693270273 |
| Mailing Telephone | 2693417806 |
| Mailing Fax Number | 2693418743 |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2020-10-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 4301068138 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4770173 | 05 | |
| MI | BCBSM - BLH | 1235131137 | 01 |
| MI | 1649250242 | 05 | |
| MI | 4681190 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801436787 | Scott Kermit Peterson | Registered Nurse | 30681 Olson St Apt 2, Pequot Lakes, MN 56472-3081 | 2020-01-08 |
| 1619413093 | Scott T Peterson | Dentist | 5235 W Baseline Rd, #187, Laveen, AZ 85339-3122 | 2017-01-10 |
| 1427202266 | Scott Andrew Peterson | Social Worker | 2000 Dry Valley Road, Loa, UT 84747 | 2008-11-06 |
| 1336398783 | Scott Allen Peterson | Occupational Therapist | 8765 Blue Pine Way, Reno, NV 89523-3843 | 2008-09-10 |
| 1013034842 | Scott L. Peterson | Counselor | 11011 S 48th St Ste 200, Phoenix, AZ 85044-1788 | 2007-03-25 |
| 1033126974 | Scott Michael Peterson | Specialist/Technologist | Lemoyne College Sports Medicine, 1419 Salt Springs Road, Syracuse, NY 13214-1399 | 2006-08-02 |
| 1750351441 | Scott David Peterson | Optometrist | 3988 Washington Blvd, Ogden, UT 84403-1826 | 2006-01-25 |
| 1457917627 | Scott Jeffrey Peterson | Social Worker | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2019-05-14 |
| 1598121808 | Scott Peterson | Ophthalmology | 3777 Coon Rapids Blvd Nw Ste 100, Coon Rapids, MN 55433-2630 | 2016-01-04 |
| 1720492655 | Scott Peterson | Marriage & Family Therapist | 1880 River Rd, Grand Rapids, MN 55744-4085 | 2014-06-18 |
| Street Address |
3300 W CENTRE AVE BRONSON OB GYN ASSOCIATES |
| City | PORTAGE |
| State | MI |
| Zip Code | 49024-4666 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790314037 | Julie Kay Stroh | Registered Nurse | 3300 W Centre Ave, Portage, MI 49024-4666 | 2020-04-08 |
| 1508324393 | Lisa Pehler Batsell | Social Worker | 3300 W Centre Ave, Portage, MI 49024-4666 | 2019-03-11 |
| 1063924926 | Jennifer Ann Soper | Nurse Practitioner | 3300 W Centre Ave, Portage, MI 49024-4666 | 2017-11-01 |
| 1083094437 | Mary Anne Dykema | Social Worker | 3300 W Centre Ave, Portage, MI 49024-4666 | 2015-06-01 |
| 1083976682 | Sara Lynn Deatsman | Obstetrics & Gynecology | 3300 W Centre Ave, Portage, MI 49024-4666 | 2012-06-11 |
| 1942506902 | Allison Elizabeth Richards | Social Worker | 3300 W Centre Ave, Portage, MI 49024-4666 | 2011-02-08 |
| 1932433935 | Lindsay Kay Remmler | Physician Assistant | 3300 W Centre Ave, Portage, MI 49024-4666 | 2009-09-23 |
| 1154654010 | Amy Elizabeth Klok | Physician Assistant | 3300 W Centre Ave, Portage, MI 49024-4666 | 2009-09-10 |
| 1720298359 | Petra Toutanji | Family Medicine | 3300 W Centre Ave, Portage, MI 49024-4666 | 2007-05-23 |
| 1285856245 | Jessica Lynn Puckett | Obstetrics & Gynecology | 3300 W Centre Ave, Portage, MI 49024-4666 | 2007-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134774524 | Antonio Richard Barron | Physician Assistant | 5717 Oakland Dr Ste A, Portage, MI 49024 | 2019-08-03 |
| 1699279240 | Julie Lynn Griffin | Specialist/Technologist | Portage Northern High School, 1000 Idaho Ave, Portage, MI 49024 | 2018-03-20 |
| 1194255711 | Brittany Lynn Finkler | Audiologist | 576 Romence Rd Ste 121, Portage, MI 49024 | 2017-06-15 |
| 1164881207 | Family & Children Services, Inc. | Clinic/Center | 1302 W Milham Ave, Portage, MI 49024 | 2016-02-17 |
| 1497127716 | Huber Counseling, LLC | Counselor | 1591 West Centre Ave, Suite 102, Portage, MI 49024 | 2015-10-26 |
| 1659757466 | Marie Porter | Rehabilitation Practitioner | 5724 Alten St, Portage, MI 49024 | 2015-08-04 |
| 1063824860 | George Hughes | General Practice | 6630 Sunburst Dr, Portage, MI 49024 | 2014-05-28 |
| 1922358407 | Kimberly Lynn Ellrich | Speech-Language Pathologist | Storypoint, 3951 W Milham Ave, Portage, MI 49024 | 2012-09-12 |
| 1942593744 | Shamika Hall, Ph.d. & Associates, Pllc | Community/Behavioral Health | 7901 S. 12th St., Suite 201, Portage, MI 49024 | 2011-05-26 |
| 1306142815 | Jody Lynn Wrathall | Dentist | 3020 Old Centre Rd, Portage, MI 49024 | 2011-01-31 |
| Find all providers in zip 49024 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992870398 | The Woman's Wellness Center, P.C. | Obstetrics & Gynecology | 3630 Willowcreek Road, Suite 10, Portage, IN 46368-5075 | 2006-11-21 |
| 1033162425 | Travis Haldeman | Obstetrics & Gynecology | 3545 Arbor Blvd, Portage, IN 46368-4298 | 2006-05-18 |
| 1801852165 | Daniel Lawrence Lott | Obstetrics & Gynecology | 3564 Scottsdale St, Portage, IN 46368-5420 | 2006-04-25 |
| 1083976682 | Sara Lynn Deatsman | Obstetrics & Gynecology | 3300 W Centre Ave, Portage, MI 49024-4666 | 2012-06-11 |
| 1538459813 | Amber Rachelle Nash-guilford | Obstetrics & Gynecology | 7895 Currier Dr, Portage, MI 49002-4314 | 2011-04-08 |
| 1083925333 | St Mary Medical Center Inc | Obstetrics & Gynecology | 3545 Arbors Street, Portage, IN 46368-4297 | 2010-07-01 |
| 1689841165 | Women's Medical Care LLC | Obstetrics & Gynecology | 3630 Willowcreek Rd, Portage, IN 46368-5075 | 2008-05-13 |
| 1285856245 | Jessica Lynn Puckett | Obstetrics & Gynecology | 3300 W Centre Ave, Portage, MI 49024-4666 | 2007-05-02 |
| 1952453474 | Jennifer Margaret Carman | Obstetrics & Gynecology | 3300 W Centre Ave, Portage, MI 49024-4666 | 2007-01-17 |
| 1104922483 | Miljan R Stankovic | Obstetrics & Gynecology | 3564 Scottsdale St, Portage, IN 46368-5420 | 2006-09-15 |
| Find all providers in PORTAGE | ||||
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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.