BLAIR SHACKLETON PETERSON PA-C - NPI 1235523721 - Physician Assistant in Dallas, TX

Q: What is Blair Peterson's NPI number?

The NPI number for Blair Peterson is 1235523721. It was assigned to this individual provider in the NPPES registry on March 24, 2015. The provider is also known as Blair Leah Shackleton Pa-C.

Q: What is Blair Peterson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Blair Peterson was last updated on February 20, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

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About Blair Shackleton Peterson Pa-c NPPES

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

BLAIR SHACKLETON PETERSON PA-C (NPI 1235523721) is an individual physician assistant in Dallas, Texas, licensed in Texas (PA09776) and active in the NPI registry since March 2015.

NPPES Registry Identity

NPI1235523721

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameBLAIR SHACKLETON PETERSONCredential: PA-C

Location Address8440 WALNUT HILL LN STE 610Dallas, TX 75231-3815

Mailing Address8440 Walnut Hill Ln Ste 610Dallas, TX 75231-3815 · (214) 345-6000 · Fax (214) 345-6026

Phone(214) 345-6000

Fax(214) 345-6026

Sole ProprietorNo

Enumeration DateMarch 24, 2015

Last NPPES UpdateFebruary 20, 20193 updates tracked since enumeration

✔ NPI 1235523721 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in TX · PA09776

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

8440 WALNUT HILL LN STE 610, Dallas, TX 75231

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Other Names 1

Former Name (1)Blair Leah Shackleton Pa-c

Other Identifiers 1

Medicaid354191401TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Community Health Choice.Insurance ›

Other Providers at the Same Location NPPES 12

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

DR. DAVID S HARPER M.D.

Internal Medicine (Cardiovascular Disease)