DR. RYAN DEAN PETERSON (NPI# 1912434432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912434432 |
| Entity Type | Individual |
| Full Name | DR. RYAN DEAN PETERSON |
| Credential | MD |
| Practice Address |
4318 Trail Boss Dr Ste 100 Castle Rock CO 80104-7512 |
| Mailing Address |
2500 S Havana St Aurora CO 80014-1618 |
| Practice Telephone | 3033384545 |
| Mailing Telephone | 3033384545 |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2020-07-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | DR.0063473 | CO | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | CO | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 9000147952 | 05 | |
| CO | KAISER COMMERCIAL NUMBER | 029036 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619354008 | Ryan Peterson | Hearing Instrument Specialist | 822 Mainstreet, Hopkins, MN 55343-7627 | 2015-05-05 |
| 1912213497 | Ryan Peterson | Counselor | 179 Morrison Ave, Somerville, MA 02144-2017 | 2010-08-23 |
| 1669613816 | Ryan Curtis Peterson | Anesthesiology | 3209 Hillock Dr, Los Angeles, CA 90068-1427 | 2009-03-18 |
| 1245486307 | Ryan Thomas Peterson | Podiatrist | 676 S Bluff St Ste 205, St George, UT 84770-3568 | 2008-08-08 |
| 1902864614 | Ryan Kent Peterson | Optometrist | 4401 E Sunset Rd, Suite 4, Henderson, NV 89014-0274 | 2006-05-02 |
| 1346237393 | Ryan Paul Peterson | Family Medicine | 1553 W 9000 S, West Jordan, UT 84088-9219 | 2005-10-04 |
| 1952908600 | Ryan Peterson | Pharmacist | 50 W Techne Center Dr Ste J, Milford, OH 45150-9798 | 2020-10-06 |
| 1124650395 | Ryan Peterson | Counselor | 3802a Grand Ave S, Minneapolis, MN 55409-1233 | 2020-02-06 |
| 1841676764 | Ryan Peterson | Dentist | 18340 Governors Hwy, Homewood, IL 60430-2910 | 2015-08-03 |
| 1992188486 | Ryan Peterson | Behavioral Analyst | 5800 S Highland Dr, Salt Lake City, UT 84121-1359 | 2015-07-02 |
| Street Address |
4318 TRAIL BOSS DR STE 100 |
| City | CASTLE ROCK |
| State | CO |
| Zip Code | 80104-7512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194066043 | Jennifer A Walker | Physician Assistant | 4318 Trail Boss Dr Ste 100, Castle Rock, CO 80104-7512 | 2013-03-01 |
| 1770970410 | Amity Onders | Family Medicine | 4318 Trail Boss Dr Ste 100, Castle Rock, CO 80104-7512 | 2015-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932737152 | F2dis, Limited Liability Company | Skilled Nursing Facility | 1055 S. Perry Street, Castle Rock, CO 80104 | 2020-04-01 |
| 1518497262 | Courtney Renee Mcmurtry | Dental Hygienist | 610 E. Fifth St., Suite 300, Castle Rock, CO 80104 | 2017-06-15 |
| 1235598350 | Village Physical Therapy, PC | Specialist | 1184 South Perry Street, Suite 230, Castle Rock, CO 80104 | 2016-02-17 |
| 1730513318 | Erin Evers | Physical Therapist | 4348 Woodlands Boulevard, Suite 100, Castle Rock, Co, CO 80104 | 2013-08-30 |
| 1730424185 | Ange' Anesthesia | Nurse Anesthetist, Certified Registered | 157 Crosshaven Pl, Castle Rock, CO 80104 | 2012-12-11 |
| 1902155013 | Rachel Everett | Marriage & Family Therapist | 831 S Perry Street, Suite 100, Castle Rock, CO 80104 | 2012-09-05 |
| 1922366889 | Health Connections of Castle Rock, Inc. | Massage Therapist | 323 Metzler Dr #105, Castle Rock, CO 80104 | 2012-04-30 |
| 1326313255 | Kate Ivey | Counselor | 4889 Thorndike Ave, Castle Rock, CO 80104 | 2012-03-10 |
| 1902106578 | Gordon Talmadge Blair IIi | Physical Therapist | 814 S. Perry St., Suit 101, Castle Rock, CO 80104 | 2010-10-28 |
| 1285943936 | Denise L Lucia | Psychologist | 509 Wilcox Street, Suite 101, Castle Rock, CO 80104 | 2010-09-29 |
| Find all providers in zip 80104 | ||||
| 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 |
|---|---|---|---|---|
| 1184928715 | David Lloyd Wood | Family Medicine | 2100 N Rocky View Rd, Castle Rock, CO 80108-9071 | 2010-12-21 |
| 1184943763 | Olga Dobranowski | Family Medicine | 6301 Ellingwood Point Pl, Castle Rock, CO 80108-9479 | 2010-05-22 |
| 1801079488 | Dalton J Mackay | Family Medicine | 651 Topeka Way Ste 600, Castle Rock, CO 80109-3116 | 2007-12-06 |
| 1922204866 | Emma V Torres Baltazar Md Pllc | Family Medicine | 606 Se Roake Avenue, Castle Rock, WA 98611 | 2007-06-26 |
| 1194807404 | Preston Keith Nein | Family Medicine | 3887 Stone Canon Ranch Rd, Castle Rock, CO 80104-2185 | 2006-10-19 |
| 1619074382 | Mihir Vikram Patel | Family Medicine | 4404 Barranca Lane, Suite 101, Castle Rock, CO 80104 | 2006-09-17 |
| 1790898849 | Dwayne Bryan Thomason | Family Medicine | 3 Oakwood Park Plz, Castle Rock, CO 80104-1887 | 2006-08-15 |
| 1619901592 | Emma V. Torres-baltazar | Family Medicine | 606 Se Roake St. / Avenue, Castle Rock Medical Clinic, Castle Rock, WA 98611 | 2006-07-10 |
| 1881660645 | Marlow Perez | Family Medicine | 831 S Perry, Suite 200, Castle Rock, CO 80104-1919 | 2006-02-23 |
| 1225018633 | Belton Douglas Hallmark | Family Medicine | 1175 S Perry St, 200, Castle Rock, CO 80104-1969 | 2006-01-20 |
| Find all providers in CASTLE ROCK | ||||
| City | CASTLE ROCK |
| Zip Code | 80104 |
Please comment or provide details below to improve the information on DR. RYAN DEAN 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.