DR. JOHN ROGER PETERSEN (NPI# 1841587854) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841587854 |
| Entity Type | Individual |
| Full Name | DR. JOHN ROGER PETERSEN |
| Credential | PH.D. |
| Practice Address |
301 University Blvd Galveston TX 77555-0551 |
| Mailing Address |
301 University Blvd Rm 5.156 Jsa Galveston TX 77555-0551 |
| Practice Telephone | 4097721350 |
| Practice Fax Number | 4097729231 |
| Mailing Telephone | 4097721350 |
| Mailing Fax Number | 4097729231 |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2011-06-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247ZC0005X |
Pathology Specialization: Clinical Laboratory Director, Non-physician |
Technologists, Technicians & Other Technical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962646224 | John Thomas Petersen | Registered Nurse | 1901 Medi Park Dr Ste 2051, Amarillo, TX 79106-2169 | 2009-04-29 |
| 1497973630 | John Robert Petersen | Chiropractor | 2216 County Road D W, Saint Paul, MN 55112-7500 | 2007-04-23 |
| 1720110737 | John William Petersen | Chiropractor | 12000 Elm Creek Blvd N Ste L70, Maple Grove, MN 55369-7167 | 2007-03-12 |
| 1851491526 | John Anthony Petersen | Psychologist | 922 E Wayne St # 205, South Bend, IN 46617-3024 | 2006-09-23 |
| 1790786895 | John Peter Petersen | Radiology | 3555 10th Court, Indian River Regional Cancer Center, Irmc, Vero Beach, FL 32960-4862 | 2005-08-10 |
| 1508422411 | John Robert Petersen | Dentist | 4555 Erin Dr, Eagan, MN 55122-3398 | 2019-05-15 |
| 1619361805 | John Devin Petersen | Pediatrics | 757 Westwood Plz, B711 Rrumc, Los Angeles, CA 90095-7419 | 2015-03-25 |
| 1114167434 | John Seigfred Petersen | Dentist | 415 Central Ave, Whitefish, MT 59937-2770 | 2009-02-26 |
| 1588868939 | John William Petersen | Internal Medicine | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2007-06-11 |
| 1164580429 | John J Petersen | Physician Assistant | 520 Medical Center Dr, Suite 201, Medford, OR 97504-4334 | 2006-12-05 |
| Street Address |
301 UNIVERSITY BLVD |
| City | GALVESTON |
| State | TX |
| Zip Code | 77555-0551 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396742714 | Bagi Rp Jana | Internal Medicine | 301 University Blvd, Galveston, TX 77555-0565 | 2005-06-30 |
| 1023617685 | Kimberly Joy Staton | Nurse Practitioner | 301 University Blvd, Galveston, TX 77555-5303 | 2020-10-23 |
| 1295333185 | Adelina Mun See Leong | Physician Assistant | 301 University Blvd, Galveston, TX 77555-3205 | 2020-10-13 |
| 1245838341 | Zachary Allen Helmick | Physician Assistant | 301 University Blvd, Galveston, TX 77555-5302 | 2020-10-12 |
| 1477150795 | Mason Juehon Yu | Physician Assistant | 301 University Blvd, Galveston, TX 77555-5302 | 2020-10-09 |
| 1336746866 | Hillary Mai | Physician Assistant | 301 University Blvd, Galveston, TX 77555-5302 | 2020-10-07 |
| 1699380139 | Sanjai Naicheril Sabu | Physician Assistant | 301 University Blvd, Galveston, TX 77555-5302 | 2020-09-11 |
| 1497369409 | Olusola Sogbein | Internal Medicine | 301 University Blvd, Galveston, TX 77555-0562 | 2020-09-08 |
| 1801409636 | Anand Kumar | Internal Medicine | 301 University Blvd, Galveston, TX 77555-0100 | 2020-08-31 |
| 1235748633 | Youlanda Martin-jones | Family Medicine | 301 University Blvd, Galveston, TX 77555-5302 | 2020-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053963389 | Ruba Riachy | Internal Medicine | The University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555 | 2019-07-16 |
| 1700362670 | Nidal Alhosainat | Internal Medicine | 301 University Blvd, 4.200 John Sealy Annex, Galveston, TX 77555 | 2018-07-13 |
| 1275915282 | Murtaza Mazhar | Internal Medicine | 301 University Blvd Cardiovascular Disease, Galveston, TX 77555 | 2015-06-25 |
| 1124469531 | Nisarg Shaileshbhai Shah | Internal Medicine | 400 Harborside Dr Suite #100, Endocrinology, Galveston, TX 77555 | 2013-07-13 |
| 1912260860 | Mohammed Fathi Zaidan | Internal Medicine | University of Texas Medical, 301 University Boulevard, Galveston, TX 77555 | 2012-06-15 |
| 1639465925 | Justin Blinn | Anesthesiology | 301 University Blvd # 2-a, Galveston, TX 77555 | 2011-06-24 |
| 1255532982 | Miguel Mauricio Cabada Samame | Internal Medicine | 301 University Boulevard Rt 0435, Galveston, TX 77555 | 2007-05-30 |
| 1154945608 | Elliot Blankespoor | Anesthesiology | 301 University Boulevard, 5.504 Jennie Sealy Hospital, Galveston, TX 77555 | 2020-06-01 |
| 1932699972 | Sara Medsker | Pediatrics | 301 University Blvd., Galveston, TX 77555 | 2018-05-15 |
| 1134297666 | Donna B Weaver | Family Medicine | 400 Harborside Dr, Galveston, TX 77555 | 2006-12-01 |
| Find all providers in zip 77555 | ||||
| Taxonomy Code | 247ZC0005X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Pathology |
| Specialization | Clinical Laboratory Director, Non-physician |
| An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405. |
| Notes: Source: National Uniform Claim Committee [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033719059 | Kenesha Barnes | Pathology | 9120 Monica St, Beaumont, TX 77707-4634 | 2020-10-28 |
| 1417574922 | Thomas King Huard | Pathology | 112 Bellagio Dr, Austin, TX 78734-5081 | 2020-06-30 |
| 1932740313 | Stephanie Halliday | Pathology | 2023 Gentryside Dr Unit 102, Houston, TX 77077-3657 | 2019-10-07 |
| 1699232504 | Xia Wang | Pathology | 1920 Country Place Pkwy # 100, Pearland, TX 77584-2282 | 2019-02-27 |
| 1982178000 | Quantacia Miner | Pathology | 613 Bridgewood Cir Apt 524, Fort Worth, TX 76112-1729 | 2019-01-11 |
| 1710479530 | Herbert A Fritsche Jr. | Pathology | 12117 Bee Caves Road, Building 3 Suite 100, Austin, TX 78738 | 2018-06-06 |
| 1336694496 | Pheleicia Biggins | Pathology | 4116 Summitt Ridge Dr, Dallas, TX 75216-6016 | 2016-08-18 |
| 1447671292 | Alvin Spiekerman | Pathology | 16300 Addison Rd, Addison, TX 75001-5346 | 2013-12-20 |
| 1659704724 | Christopher Byers | Pathology | 6682 Escondido St, Irving, TX 75039-4208 | 2013-08-13 |
| 1740567841 | Stephen Ray Harlow | Pathology | 201 Laurence, #108, Heath, TX 75032 | 2011-11-03 |
| Find all providers with the same taxonomy | ||||
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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.