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ERIC TAYLOR PETERSON DO
NPI 1376395400
Student in an Organized Health Care Education/Training Program in Las Vegas, NV

Active since April 02, 2024PECOS Enrolled
620 SHADOW LN, LAS VEGAS, NV 89106(707) 388-8436 Get Directions Write a Review

NPPES record last updated: June 16, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 16, 2025, May 22, 2025, Apr 2, 2024 (3 updates tracked since 2024).

About Eric Taylor Peterson Do NPPES

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

ERIC TAYLOR PETERSON DO (NPI 1376395400) is an individual student in an organized health care education/training program in Las Vegas, Nevada and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376395400
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameERIC TAYLOR PETERSONCredential: DO
Location Address620 SHADOW LNLas Vegas, NV 89106-4194
Mailing AddressValley Hospital Medical Center, 620 Shadow LaneLas Vegas, NV 89106 · (707) 388-8436
Phone(707) 388-8436
Sole ProprietorNo
Enumeration DateApril 2, 2024
Last NPPES UpdateJune 16, 20253 updates tracked since enumeration
NPPES CertifiedJune 16, 2025
✔ NPI 1376395400 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

620 SHADOW LN, Las Vegas, NV 89106
Open in Google Maps ↗

Other Names 1

Professional Name (2)Dr. Eric Taylor Peterson Do

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eric Taylor Peterson Do 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.

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.

JANN STACEY PICKENS NP
Nurse Practitioner
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-4506
DR. VICTOR HOANG D.O.
Orthopaedic Surgery
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-8436
DR. KAY E MCMILLAN DO
Emergency Medicine
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-4500
DR. FELIX ALEXIE DO
Internal Medicine
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-4000
ALEX HIRSCHFELD GOLDBACH MD
Internal Medicine
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 477-6572
NASIBO KADIR MD PLLC
Internal Medicine
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-4000
DR. JOHN YOUNG KO DO
Internal Medicine (Gastroenterology)
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-8436
DR. NICHOLAS CIURCZAK DO
Student in an Organized Health Care Education/Training Program
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-4000

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 Eric Peterson's NPI number?

The NPI number for Eric Peterson is 1376395400. It was assigned to this individual provider in the NPPES registry on April 2, 2024. The provider is also known as Dr. Eric Taylor Peterson Do.

Where is Eric Peterson located?

Eric Peterson practices at 620 Shadow Ln, Las Vegas, NV 89106. The listed phone number is (707) 388-8436.

What is Eric Peterson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Eric Peterson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Eric Peterson was last updated on June 16, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.