Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1245396662 Deactivated / Inactive NPI Male Practitioner

Dr. John M. Peterson , MD

Pediatrics • Roseburg, OR

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. John Peterson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 29, 2006
NPI Deactivation Date February 21, 2024
Total Practice Duration ~18 Years of Practice (2006 – 2024)

Professional Overview & Biography Verified Profile Summary

Dr. John Peterson, MD was a registered Pediatrics practicing in Roseburg, OR. Throughout an active medical career spanning 18 years, Dr. Peterson provided care at the practice location at 150 KENNETH FORD DRIVE until profile deactivation on 2024-02-21.

Practice Location & Contact Primary Location

Practice Address

150 Kenneth Ford Drive

Roseburg, OR 974701042

Telephone 5416729596
Fax 5414643519
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Roseburg, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 29.5 Yrs
State Avg: 20.9 Yrs
Regional Practice Density
13 Specialists

Practicing in Roseburg, OR (880 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License WA MD00018578

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Misha Peel , DO

Family Medicine

NPI 1003374323

Doctor of Osteopathic Medicine (D.O.)

Dr. Justin Jones , DDS

Dentist - Dental Public Health

NPI 1013083427

Doctor of Dental Surgery

Dr. John Melling , MD

Family Medicine

NPI 1013536382

Doctor of Medicine (M.D.)

NPI 1023701984

Doctor of Dental Medicine

Dr. Jordan Endres , DDS

Dentist - General Practice

NPI 1083073522

Doctor of Dental Surgery

Mirranda Mandera , CHW

Community Health Worker

NPI 1093404725

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
⚠️
NPI Profile Deactivated February 21, 2024

Record deactivated on February 21, 2024

NPI Profile Active December 15, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location December 15, 2011

Registered at 150 KENNETH FORD DRIVE, ROSEBURG, OR 974701042 (Tel: 5416729596)

📍
Updated Business Mailing Address December 15, 2011

Registered at 150 KENNETH FORD DRIVE, ROSEBURG, OR 974701042 (Tel: 5416729596)

👤
Provider Name / Credentials Updated December 15, 2011

Recorded as JOHN PETERSON, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 15, 2011

Pediatrics (License #MD00018578 in WA)

🟢
Initial NPI Registration & Enumeration December 29, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. John Peterson. Be the first to share your experience!

Sign in to leave a review for Dr. John Peterson

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1245396662
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 29, 2006
Last Update: December 15, 2011
Deactivation Date: February 21, 2024

Mailing Address

150 Kenneth Ford Drive

Roseburg, OR 974701042

Phone: 5416729596

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.