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SHANE L PETERSEN MD NPI 1770593246


NPI Information

NPI: 1770593246
Provider Name: SHANE L PETERSEN, MD
Classification: Anesthesiology - 207L00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
5121 S COTTONWOOD STREET
INTERMOUNTAIN MEDICAL CENTER
MURRAY, UT
ZIP 84157
Phone: (801) 507-5248
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Shane L Petersen, MD is an anesthesiology in Murray, UT with 23 years of experience. The provider is an anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. Shane L Petersen, MD NPI is 1770593246. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduation Year:2001

The provider's business location address is:

5121 S COTTONWOOD STREET
INTERMOUNTAIN MEDICAL CENTER
MURRAY, UT
ZIP 84157
Phone: (801) 507-5248
Fax: (801) 733-5618

The NPI 1770593246 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/8/2006 and was last updated on 10/15/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207L00000XAnesthesiology2434068-1205UTAHYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1107038030101OTHERUTAHIHC
224340681200001OTHERUTAHREGENCE BCBS
3QM0000075886OTHERUTAHALTIUS
4100506343MEDICAIDNEVADA
5807171600MEDICAIDIDAHO
6941379MEDICAIDARIZONA
7055327146MEDICARE ID-TYPE UNSPECIFIEDUTAH
883770OTHERUTAHPEHP
9907869OTHERUTAHDESERET MUTUAL
1099469OTHERUTAHHEALTHY U
11121124200MEDICAIDWYOMING
121502954OTHERUTAHUMWA
132090168OTHERUTAHUNITED HEALTHCARE
14QMP000003262280OTHERUTAHMOLINA
15I39965MEDICARE UPINUTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.