CARL PETERS MD NPI 1053403915

NPI Information

NPI: 1053403915
Provider Name: CARL PETERS, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
307 NOONAN DR
PACIFIC, MO
ZIP 63069
Phone: (636) 271-9100
Get Directions

Carl Peters, MD is a family medicine in Pacific, MO. The provider is 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. Carl Peters, MD NPI is 1053403915. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

307 NOONAN DR
PACIFIC, MO
ZIP 63069-136
Phone: (636) 271-9100
Fax: (636) 257-6016

The enumeration date for this NPI number is 9/29/2006 and was last updated on 7/15/2011.

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
1	207Q00000X	Family Medicine		036099983	ILLINOIS	Yes

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
1	L71591	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS	INDIVIDUAL #
2	129430024	MEDICARE PIN
3	G97354	MEDICARE UPIN
4	CA2264	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS	RR GROUP #
5	036099983	MEDICAID	ILLINOIS
6	205521800	MEDICAID	MISSOURI
7	080145857	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS	RR INDIVIDUAL #
8	833130	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS	GROUP #

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: 4/28/2024

NPI Synchronization or Removal

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