PETERSON MEDICAL LLC
NPI 1033762513
Nurse Practitioner - Family in Blanchard, OK

NPI Status: Active since July 23, 2019

Contact Information

217 N HARRISON AVE
BLANCHARD, OK
ZIP 73010
Phone: (405) 631-0611

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  • Organization
  • Nurse Practitioner
  • Family
  • CLIA Number: 37D2179425
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 02-23-2026

About PETERSON MEDICAL LLC

This page provides the complete NPI Profile along with additional information for Peterson Medical Llc, a provider established in Blanchard, Oklahoma operating as a Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1033762513 assigned on July 2019. The practitioner's primary taxonomy code is 363LF0000X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Braden Peterson Np (Member)

NPI
1033762513
Provider Name
PETERSON MEDICAL LLC
Entity Type
Organization
Location Address
217 N HARRISON AVE BLANCHARD, OK 73010
Location Phone
(405) 631-0611
Mailing Address
701 NE 36TH ST OKLAHOMA CITY, OK 73105
Mailing Phone
(405) 631-0611
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-23-2019
Last Update Date
07-23-2019
Code Navigator

A nurse practitioner (NP) like Peterson Medical Llc is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner Family

Taxonomy Code
363LF0000X
Type
Physician Assistants & Advanced Practice Nursing Providers

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

BRADEN PETERSON NP

Authorized Official Title
MEMBER
Authorized Official Phone
(580) 235-1657

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
37D2179425
Facility Type
Physician Office
Certificate Effective Date
February 24, 2024
Certificate Expiration Date
February 23, 2026
Laboratory Director
STEVEN BANDER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Peterson Medical Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1033762513, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
3
Doubled → 6
Pos 4
3
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
6
Unchanged
Pos 7
2
Doubled → 4
Pos 8
5
Unchanged
Pos 9
1
Doubled → 2
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 7 → 14 → 5 2 → 4 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 6 + 3 + 1 + 4 + 6 + 4 + 5 + 2 + 24 = 57

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1033762513.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1033762513, enumerated as an "organization" on July 23, 2019.

The provider is located at 217 N HARRISON AVE BLANCHARD, OK 73010 and the phone number is (405) 631-0611.

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.