TIMOTHY WARREN PETERSON (NPI# 1720388218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720388218 |
| Entity Type | Individual |
| Full Name | TIMOTHY WARREN PETERSON |
| Credential | P.A. |
| Practice Address |
85 N Grand Ave Fort Thomas KY 41075-1793 |
| Mailing Address |
Po Box 18667 Erlanger KY 41018-0667 |
| Practice Telephone | 8595723617 |
| Practice Fax Number | 8595722326 |
| Mailing Telephone | 8595723617 |
| Mailing Fax Number | 8595722326 |
| Enumeration Date | 2010-10-30 |
| Last Update Date | 2015-07-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA1799 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100252800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023178738 | Timothy Lee Peterson | Pharmacist | 1010 Enterprise Dr E, Belle Plaine, MN 56011-2340 | 2006-12-11 |
| 1992887376 | Timothy K. Peterson | Physician Assistant | 2891 E Grant St, Roma, TX 78584 | 2006-10-19 |
| 1609956481 | Timothy John Peterson | Chiropractor | 10135 Hwy Ss, Bloomer, WI 54724 | 2006-10-16 |
| 1528041886 | Timothy D Peterson | Emergency Medicine | 108 Sutton Place, Taos Ski Valley, NM 87525-0067 | 2005-11-21 |
| 1265049043 | Timothy Charles Peterson | Pharmacist | 1400 E 2nd St, Edmond, OK 73034-5321 | 2020-09-25 |
| 1740742725 | Timothy Scott Peterson | Student in an Organized Health Care Education/Training Program | 2301 Erwin Rd, Durham, NC 27705-4699 | 2019-04-01 |
| 1497259360 | Timothy James Peterson | Student in an Organized Health Care Education/Training Program | 1740 W Taylor St, Chicago, IL 60612-7232 | 2018-03-23 |
| 1992189328 | Timothy James Peterson | Counselor | 12025 115th Ave Ne, Bldg D Suite 200, Kirkland, WA 98034-6942 | 2015-07-15 |
| 1730518044 | Timothy Terrence Peterson | Pharmacist | 4500 Commercial St Se, Salem, OR 97302-3918 | 2013-11-06 |
| 1922362490 | Timothy Peterson | Family Medicine | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2012-06-29 |
| Street Address |
85 N GRAND AVE |
| City | FORT THOMAS |
| State | KY |
| Zip Code | 41075-1793 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467458745 | Kevin C Meyer | Emergency Medicine | 85 N Grand Ave, Fort Thomas, KY 41075 | 2005-06-22 |
| 1538760020 | Megan Sullivan | Registered Nurse | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2020-11-03 |
| 1407472699 | Rachael M Oakley | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2020-06-23 |
| 1720626856 | Natalya C Williams | Nurse Practitioner | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2019-12-19 |
| 1710537675 | Kaitlyn Gerrety | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2019-09-12 |
| 1578039632 | Samuel Quincy Gaines | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2018-10-16 |
| 1790209476 | Shelby Rene Mesch | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2017-08-03 |
| 1538681044 | Danielle Nichole Fryer | Registered Nurse | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2017-07-17 |
| 1427596675 | Donna Gentz | Physical Therapy Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2017-02-08 |
| 1063967495 | Cora E Mikesell | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2016-08-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023630472 | Reliable Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 604 South Fort Thomas Avenue, Fort Thomas, KY 41075 | 2020-05-08 |
| 1245878149 | A & A Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 604 South Ft. Thomas, Ft. Thomas, KY 41075 | 2019-12-11 |
| 1588213383 | Connect Counselors | Social Worker | 1051 Alexandria Pike, Suite 104, Fort Thomas, KY 41075 | 2019-09-05 |
| 1629634407 | Kristen Lynn Salvato | Counselor | 18 North Fort Thomas Avenue, Suite 109, Fort Thomas, KY 41075 | 2019-05-16 |
| 1306364872 | Mary Frances Scott | Developmental Therapist | 26 Burney Ln, Ft Thomas, KY 41075 | 2017-09-06 |
| 1881123057 | Samuel Barth | Specialist/Technologist | 33 Bellaire Place, Fort Thomas, KY 41075 | 2017-06-09 |
| 1669918371 | Jenna Weyer | Specialist/Technologist | 46 Fischer Lane, Fort Thomas, KY 41075 | 2017-01-19 |
| 1457723033 | Lauren Bradbury | Registered Nurse | 1201 N. Ft. Thomas Ave., Ft. Thomas, KY 41075 | 2015-10-22 |
| 1053639237 | Kathy H Kugler | Psychologist | 1201 South Ft Thomas Ave, Ft Thomas, KY 41075 | 2010-05-12 |
| 1104059229 | Shanna L Murray | Psychologist | 1000 S. Ft. Thomas Ave, Fort Thomas, KY 41075 | 2009-08-24 |
| Find all providers in zip 41075 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407472699 | Rachael M Oakley | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2020-06-23 |
| 1710537675 | Kaitlyn Gerrety | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2019-09-12 |
| 1578039632 | Samuel Quincy Gaines | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2018-10-16 |
| 1790209476 | Shelby Rene Mesch | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2017-08-03 |
| 1063967495 | Cora E Mikesell | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2016-08-15 |
| 1841696739 | Compass Emergency Physicians Psc | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2014-11-05 |
| 1841695905 | Natalie N Webb | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2014-10-30 |
| 1740616010 | Kimberly K Edwards | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2013-09-18 |
| 1053753434 | Catherine Kremer | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2013-07-25 |
| 1235480856 | Christi Strole | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2012-09-21 |
| Find all providers in FORT THOMAS | ||||
| City | FORT THOMAS |
| Zip Code | 41075 |
Please comment or provide details below to improve the information on TIMOTHY WARREN PETERSON.
| 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.