JOHN CHARLES PETERSON M.D. NPI 1508880642

NPI Information

  • NPI: 1508880642
  • Provider Name: JOHN CHARLES PETERSON, M.D.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • CLIA Number: 15D0359964
  • Address: 100 N TILLOTSON AVE
    MUNCIE, IN
    ZIP 47304
  • Phone: (765) 282-7475

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NPI Details

John Charles Peterson, M.D. is a family medicine in Muncie, IN with 51 years of experience. 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. John Charles Peterson, M.D. NPI is 1508880642. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF IOWA, RJ & L CARVER COLLEGE OF MEDICINE
Graduation Year:1974

The provider's business location address is:

100 N TILLOTSON AVE
MUNCIE, IN
ZIP 47304-987
Phone: (765) 282-7475

The NPI 1508880642 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 CLIA number assigned to this NPI record is 15D0359964 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Initial hospital inpatient care per day, typically 70 minutes (HCPCS:99223)
  • Injection of drug or substance under skin or into muscle (HCPCS:96372)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Hospital discharge day management, 30 minutes or less (HCPCS:99238)
  • Hospital discharge day management, more than 30 minutes (HCPCS:99239)

The enumeration date for this NPI number is 7/26/2006 and was last updated on 9/27/2012.

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
1207Q00000XFamily Medicine10027232INDIANAYes

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
1100106190AMEDICAIDINDIANA
2204010MEDICARE ID-TYPE UNSPECIFIEDINDIANA
3D69461MEDICARE UPININDIANA

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: 3/30/2025

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