PETERSON PT LLC
PETERSON PT LLC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1669480968, based in Prescott, AZ. It is classified under Pediatric Sports Medicine Physician.
Getting there
The practice address on file is 1320 W IRON SPRINGS RD, Prescott, AZ 86305. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 5079 | AZ | Pediatric Sports Medicine Physician primary |
| 5810 | AZ | Pediatric Sports Medicine Physician |
| 6499 | AZ | Pediatric Sports Medicine Physician |
This provider holds licence 5079 issued in AZ. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Part B Supplier - Clinic/group Practice
- PAC ID
- 1850385824
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Clinic/group Practice. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Sports Medicine covers
A pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual engaged in physical exercise (sports) whether as an individual or in team participation. NUCC Health Care Provider Taxonomy, code 2080S0010X
All registered taxonomy codes
This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 2080S0010X | Pediatric Sports Medicine Physician Sports Medicine | 5079 | AZ | primary |
| 2080S0010X | Pediatric Sports Medicine Physician Sports Medicine | 5810 | AZ | |
| 2080S0010X | Pediatric Sports Medicine Physician Sports Medicine | 6499 | AZ |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1669480968 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Aug 3, 2006 |
| Last updated | May 20, 2024 |
| Status | Active |
| Practice address |
1320 W IRON SPRINGS RD Prescott, AZ 86305 (928) 771-2977 Fax (928) 771-2987 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 6 | 6 | 9 | 4 | 8 | 0 | 9 | 6 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 6 | 3 | 9 | 8 | 8 | 0 | 9 | 3 |
Sum = 72 · next multiple of 10 = 80 · check digit = 8 · actual last digit = 8
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.