DR. SHAWN PETERSON M.D. NPI 1710392477

NPI Information

NPI: 1710392477
Provider Name: DR. SHAWN PETERSON, M.D.
Classification: Internal Medicine - 207RX0202X
Entity Type: Individual

Specialization: Medical Oncology

PECOS Registration: Yes

Address:
1700 NICHOLASVILLE RD STE 1100
LEXINGTON, KY
ZIP 40503
Phone: (859) 276-0414
Get Directions

DR. Shawn Peterson, M.D. is a medical oncology internal medicine in Lexington, KY with 10 years of experience. The provider is an internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer. DR. Shawn Peterson, M.D. NPI is 1710392477. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE
Graduation Year:2014

The provider's business location address is:

1700 NICHOLASVILLE RD STE 1100
LEXINGTON, KY
ZIP 40503-466
Phone: (859) 276-0414

The NPI 1710392477 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 6/21/2014 and was last updated on 12/7/2020.

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	207R00000X	Internal Medicine		R3588	KENTUCKY	No
2	207RH0000X	Internal Medicine	Hematology	50117	KENTUCKY	No
3	390200000X	Student in an Organized Health Care Education/Training Program				No
4	207RX0202X	Internal Medicine	Medical Oncology	50117	KENTUCKY	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	7100367380	MEDICAID	KENTUCKY

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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