DR. KEVIN PETERSEN MD
NPI 1205971066
Specialist in Las Vegas, NV

Active since February 20, 2007
653 N TOWN CENTER DR, LAS VEGAS, NV 89144(702) 256-7616(702) 256-1481 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Kevin Petersen Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KEVIN PETERSEN MD (NPI 1205971066) is an individual specialist in Las Vegas, Nevada, licensed in Nevada (9665) and active in the NPI registry since February 2007.

NPPES Registry Identity

NPI1205971066
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameDR. KEVIN PETERSENCredential: MD
Location Address653 N TOWN CENTER DRLas Vegas, NV 89144-0514
Mailing Address653 N Town Center DrLas Vegas, NV 89144-0514 · (702) 256-7616 · Fax (702) 256-1481
Fax(702) 256-1481
Sole ProprietorYes
Enumeration DateFebruary 20, 2007
Last NPPES UpdateJuly 9, 2007
NPI 1205971066 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License Licensed in NV · 9665
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

653 N TOWN CENTER DR, Las Vegas, NV 89144

Other Identifiers 3

Medicare UPIND16255NV
Medicare PIN36075NV
Medicare ID-Type Unspecified36074NV · Medicare Group

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Plastic Surgery
653 N TOWN CENTER DR, SUITE 108
LAS VEGAS, NV 89144
Anesthesiology
653 N TOWN CENTER DR, SUITE 402
LAS VEGAS, NV 89144
Pediatrics
653 N TOWN CENTER DR, SUITE 106
LAS VEGAS, NV 89144
Obstetrics & Gynecology
653 N TOWN CENTER DR, SUITE 514
LAS VEGAS, NV 89144
Obstetrics & Gynecology (Gynecology)
653 N TOWN CENTER DR, SUITE 214
LAS VEGAS, NV 89144
Internal Medicine (Gastroenterology)
653 N TOWN CENTER DR, SUITE #604
LAS VEGAS, NV 89144
Pediatrics (Pediatric Critical Care Medicine)
653 N TOWN CENTER DR, STE 408
LAS VEGAS, NV 89144
Physical Medicine & Rehabilitation
653 N TOWN CENTER DR
LAS VEGAS, NV 89144

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Petersen's NPI number?

The NPI number for Kevin Petersen is 1205971066. It was assigned to this individual provider in the NPPES registry on February 20, 2007.

Where is Kevin Petersen located?

Kevin Petersen practices at 653 N Town Center Dr, Las Vegas, NV 89144. The listed phone number is (702) 256-7616.

What is Kevin Petersen's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Kevin Petersen was last updated on July 9, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.