Dr. Caitlin Gannon Peterson

DO | Pediatric Nephrology | Female

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Complete Profile:

Dr. Caitlin Gannon Peterson basic information including her official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics Pediatric Nephrology
Provider Name :	Dr. Caitlin Gannon Peterson
Other Name :	Caitlin Rebecca Gannon
Credential :	DO
Gender :	Female
Sole Proprietor :	Yes

Business Address:

Dr. Caitlin Gannon Peterson address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	100 N Mario Capecchi Dr Salt Lake City, UT, 84113-1103 United States
Phone Number :	801-662-1000

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1760742530
NPI Entity Type :	Individual
First Enrolment Date :	25 May, 2012
Last Updated On :	11 Nov, 2021

Medicare Participation:

Dr. Caitlin Gannon Peterson participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	6709024599
Medicare Enrollment ID :	I20180510000786
Primary Specialty :	Pediatric Medicine
Medical School :	Other
Graduation Year :	2012
Accepts Medicare?	Yes. Dr. Caitlin Gannon Peterson accepts medicare insurance.

Group Practice Association:

Dr. Caitlin Gannon Peterson is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Dr. Caitlin Gannon Peterson is associated with along with the number of members in that group. She may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
Intermountain Healthcare Services, Inc	1850209420	2610	100 N Mario Capecchi Dr Salt Lake City, UT - 841131103 Ph: 8016621000	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Caitlin Gannon Peterson are as mentioned. Primary taxonomy code for Dr. Caitlin Gannon Peterson, DO is 2080P0210X (Pediatrics Pediatric Nephrology).

Taxonomy Code	Speciality	Primary	License No.	State
390200000X	Student in an Organized Health Care Education/Training Program	No
2080P0210X	Pediatrics Pediatric Nephrology	Yes	10784090-1204	UT

Endpoints:

Endpoints provide a simple, secure, scalable, and standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. It is used by EHR systems (Electronic Health Records).

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	Po Box 30180 Salt Lake City, UT, 84130-0180 United States

Business Location:

Patients can refer following map for directions to Dr. Caitlin Gannon Peterson practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.