DR. MICHAEL CHARLES PETERSEN


Address: 12356 Riata Trace Pkwy # 6006-b, Austin, TX 78727-6417
Phone: 5125067000

DR. MICHAEL CHARLES PETERSEN (NPI# 1881798379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1881798379
Entity Type Individual
Full Name DR. MICHAEL CHARLES PETERSEN
Credential M.D.
Practice Address 12356 Riata Trace Pkwy # 6006-b
Austin
TX 78727-6417
Practice Telephone 5125067000
Practice Fax Number 3142514450
Mailing Telephone 5125067000
Mailing Fax Number 3142514450
Enumeration Date 2006-09-12
Last Update Date 2019-09-04
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 208000000X Pediatrics 2006027561 MO Allopathic & Osteopathic Physicians
Y 2080P0204X Pediatrics
Specialization: Pediatric Emergency Medicine
Q2049 TX Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
621 S New Ballas Rd, 6006-b, Saint Louis, MO 631418232 3142516299 3142514450

Other Providers MICHAEL PETERSEN

NPI Name Taxonomy Address Enumeration
1740602960 Michael Petersen Veterinarian 5754 Nicollet Ave, Minneapolis, MN 55419-2415 2014-01-07
1407902307 Michael James Petersen Dentist 3101 Old Highway 8, Suite #303, Roseville, MN 55113-1072 2007-01-25
1629005160 Michael R Petersen Ophthalmology 2000 N Huron River Dr Ste 100, Ypsilanti, MI 48197 2006-06-28
1467428656 Michael S Petersen Orthopaedic Surgery 2020 Sutter Pl, Suite 104, Davis, CA 95616-6213 2006-02-27
1609849736 Michael T Petersen Anesthesiology 25 Main Pl, Suite 425, Council Bluffs, IA 51503-0792 2006-02-09
1639785579 Michael Lee Petersen Pharmacist 900 W Clairemont Ave, Eau Claire, WI 54701-6122 2020-09-16
1780248146 Michael Jake Petersen Student in an Organized Health Care Education/Training Program 600 S Paulina St Ste 403, Chicago, IL 60612-3806 2019-04-30
1093182552 Michael Petersen Counselor 1067 E Tabernacle St, Suite 7, Saint George, UT 84770-3163 2015-08-31
1972746931 Michael G Petersen Physician Assistant 7201 Manchaca Rd, Ste B, Austin, TX 78745-5283 2009-04-07
1518974153 Michael J Petersen Podiatrist 3922 Mercy Dr, Mchenry, IL 60050-3151 2006-08-02

Office Location

Street Address 12356 RIATA TRACE PKWY # 6006-B
City AUSTIN
State TX
Zip Code 78727-6417

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1255953188 Kassidy Lewis Specialist/Technologist 12708 Riata Vista Circle, A 106, Austin, TX 78727 2020-05-14
1922632405 Little Light Aba, LLC Behavioral Analyst 6001 W Parmer Ln Ste 370 #3064, Austin, TX 78727 2020-02-24
1497239081 Alison Laurie Cook Speech-Language Pathologist 13112 Kellies Farm Lane, Austin, TX 78727 2018-09-19
1326529371 Excelsior Anesthesia Pllc Anesthesiology 12728 Council Bluff Dr, Austin, TX 78727 2018-08-28
1992227847 Kathryn Ann Aldridge Registered Nurse 12608 Terra Nova Ln, Austin, TX 78727 2017-07-12
1912431404 Harry Lundell Counselor 5404 Pony Chase, Austin, TX 78727 2017-04-12
1811364078 Peoples Pharmacy Pharmacy 5505 W. Parmer Lane, Building 4, At Apple Wellness Center, Austin, TX 78727 2015-08-24
1346665080 Emily Doubt Chiropractic Pllc Chiropractor 3951 W Parmer Ln Ste. 300, Austin, TX 78727 2014-03-04
1053689745 Rahim & Karim, Inc Durable Medical Equipment & Medical Supplies 1914 W. Howard Lane, Suite C, Austin, TX 78727 2011-12-08
1538445937 Thyroid Cytopathology Partners Pa Pathology 12357 A Riata Trace Parkway, Bldg. 5, Suite 100, Austin, TX 78727 2011-10-30
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Taxonomy Information

Taxonomy Code 2080P0204X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Pediatric Emergency Medicine

Taxonomy Definition

A pediatrician who has special qualifications to manage emergencies in infants and children.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1538502851 Nidhi Singh Pediatrics 4900 Mueller Blvd, Austin, TX 78723-3079 2013-04-17
1083957427 Megan Mcclung Pediatrics 4900 Mueller Blvd, Dept of Pediatric Emergency Medicine, Austin, TX 78723 2013-04-04
1952694556 Catherine Elaine Yee Pediatrics 4900 Mueller Blvd, Suite 3e.003, Austin, TX 78723-3079 2011-05-16
1184815227 Pediatric Surgical Subspecialists Pediatrics 1301 Barbara Jordan Blvd Ste 307, Austin, TX 78723-3080 2007-08-05
1144300419 Andrew Joseph Kienstra Pediatrics 4900 Mueller Blvd, Austin, TX 78723-2303 2006-10-17
1932137965 Winnie T Whitaker Pediatrics 6300 La Calma Dr Ste 200, Austin, TX 78752-3825 2006-06-29

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1285017343 Leilani So Wiltz Pediatrics 3 Abbotsford Court, Dallas, TX 75225 2015-07-07
1598183840 Brian Lonquich Pediatrics 2450 Holcombe Blvd Ste Nb-34l, Houston, TX 77021-2039 2014-04-03
1134278476 Carla Magnolia Laos Pediatrics 6621 Fannin St Ste A.210, Texas Children's Hospital Bcm C/o Peggy Womack, Houston, TX 77030-2303 2007-01-09
1679653919 Mark Ward Pediatrics 6621 Fannin St, Mc A1170, Houston, TX 77030-2303 2006-10-17
1124631437 Kids Care Pllc Pediatrics 500 E Houston St, Beeville, TX 78102-4941 2020-08-26
1679935613 Alecia Borkovich Pediatrics 6701 Fannin St, Houston, TX 77030-2608 2016-03-28
1164819975 Shelease O'bryant Pediatrics 6621 Fannin St, Houston, TX 77030-2358 2015-04-20
1972997500 Alexander Henri Pediatrics 315 N San Saba Ste 1135, San Antonio, TX 78207 2015-03-20
1831506757 Sheetal Khiyani Pediatrics 333 N Santa Rosa St, San Antonio, TX 78207-3108 2014-07-14
1386059087 Asha Tharayil Pediatrics 5323 Harry Hines Blvd Stop 7200, Dallas, TX 75390-4637 2014-06-23
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Competitor

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City AUSTIN
Zip Code 78727

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Dataset Information

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.

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