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DAVID PETERSON JR.
NPI 1366823858
Residential Treatment Facility, Emotionally Disturbed Children in Denver, CO

Active since June 10, 2015PECOS Enrolled
10350 E DAKOTA AVE STE B, DENVER, CO 80247(303) 338-4545 Get Directions Write a Review

NPPES record last updated: May 21, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About David Peterson Jr. NPPES

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

DAVID PETERSON JR. (NPI 1366823858) is an individual residential treatment facility, emotionally disturbed children provider in Denver, Colorado, licensed in Colorado (LPC.0012467) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS and maintains a secondary practice location in Aurora.

NPPES Registry Identity

NPI1366823858
Entity TypeIndividualMale
Primary Taxonomy322D00000X
Provider Legal NameDAVID PETERSON JR.
Location Address10350 E DAKOTA AVE STE BDenver, CO 80247-1314
Mailing Address10350 E Dakota AveDenver, CO 80247-1314
Phone(303) 338-4545
Sole ProprietorYes
Enumeration DateJune 10, 2015
Last NPPES UpdateMay 21, 2021
NPPES CertifiedMay 21, 2021
✔ NPI 1366823858 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities
Taxonomy Code322D00000X
License✔ Licensed in CO · LPC.0012467
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
10350 E DAKOTA AVE STE B, Denver, CO 80247
Open in Google Maps ↗

Secondary Practice Location 1

Location 11290 S Potomac StAurora, CO 80012-4524 · Phone (303) 597-2268

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

David Peterson Jr. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show David Peterson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Colorado Permanente Medical Group, P.C.
Same address
Internal Medicine
10350 E DAKOTA AVE
Denver, CO 80247
  • Reassigned Medicare billing, Colorado enrollment
  • Medicare enrollment name: Colorado Permanente Medical Group PC
  • 1,715 clinicians in this Medicare group
NPI 1760599724 (303) 338-4545

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

SHANNON MICHELLE PAULSON LPC
Counselor (Professional)
10350 E DAKOTA AVE STE B
DENVER, CO 80247
Denver County (303) 338-4545
DR. CHRISTOPHER THOMAS BAYLEY M.D.
Psychiatry & Neurology (Psychiatry)
10350 E DAKOTA AVE STE B
DENVER, CO 80247
Denver County (303) 338-4545
JAMES TEEMS LMHC
Counselor (Professional)
10350 E DAKOTA AVE STE B
DENVER, CO 80247
Denver County (303) 338-4545
MS. JILLIAN E MORRISON LCSW, LAC, MAC, ACS
Social Worker (Clinical)
10350 E DAKOTA AVE STE B
DENVER, CO 80247
Denver County (303) 338-4545
DR. KRISTIN NOEL ROSSEAU MD, MS
Psychiatry & Neurology (Psychiatry)
10350 E DAKOTA AVE STE B
DENVER, CO 80247
Denver County (303) 338-4545
DR. ANDREA KOHN MAIKOVICH-FONG PH.D., ABPP
Psychologist (Clinical)
10350 E DAKOTA AVE STE B
DENVER, CO 80247
Denver County (303) 338-4545
DR. JULIE NICOLE LEMOINE M.D
Obstetrics & Gynecology
10350 E DAKOTA AVE STE B
DENVER, CO 80247
Denver County (303) 338-4545
DR. CHLOE JING YUAN MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
10350 E DAKOTA AVE STE B
DENVER, CO 80247
Denver County (303) 338-4545

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 David Peterson's NPI number?

The NPI number for David Peterson is 1366823858. It was assigned to this individual provider in the NPPES registry on June 10, 2015.

Where is David Peterson located?

David Peterson practices at 10350 E Dakota Ave Ste B, Denver, CO 80247. The listed phone number is (303) 338-4545.

What is David Peterson's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

Is David Peterson enrolled in Medicare?

Yes. David Peterson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for David Peterson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), David Peterson reassigns Medicare benefits to Colorado Permanente Medical Group, P.C. (Denver, CO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for David Peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for David Peterson was last updated on May 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.