Healther Providers Data Logo


Provider Type Icon

DR. GERALD DUDLEY PETERSON DPM NPI 1316983513


NPI Information

NPI: 1316983513
Provider Name: DR. GERALD DUDLEY PETERSON, DPM
Classification: Podiatrist - 213ES0103X
Entity Type: Individual

Specialization: Foot & Ankle Surgery

PECOS Registration: Yes

Address:
1880 WILLAMETTE FALLS DR
SUITE 111
WEST LINN, OR
ZIP 97068
Phone: (503) 657-1900
Get Directions

DR. Gerald Dudley Peterson, DPM is a foot and ankle surgery podiatrist in West Linn, OR. DR. Gerald Dudley Peterson, DPM NPI is 1316983513. 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:

1880 WILLAMETTE FALLS DR
SUITE 111
WEST LINN, OR
ZIP 97068-652
Phone: (503) 657-1900
Fax: (503) 657-7744

The NPI 1316983513 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).

The enumeration date for this NPI number is 6/22/2006 and was last updated on 8/29/2011.


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
1213ES0103XPodiatristFoot & Ankle Surgery118OREGONYes

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
1168161MEDICAIDOREGON
2T68008MEDICARE UPINOREGON
30915940001MEDICARE NSCOREGON
4930743342OTHEROREGONBCBS OF OREGON
5R0000SGBDJMEDICARE PINOREGON

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
Remove or sync iconNPI Synchronization or Removal

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.

« Previous NPI
Next NPI »