Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Cody Allen Peterson, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1245764117

Cody Allen Peterson, MD is an Emergency Medicine in Pocatello, Idaho. Graduated from University of Alabama School of Medicine in 2017, 9 years ago. Practices with Emergency Physicians Integrated Care LLC, a 203-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
9
Trained at
University of Alabama School of Medicine
Licensed in
ID
In the registry since
2017
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

777 Hospital Way
Pocatello, ID 83201-5175
Phone: (208) 417-7569
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence TLM-4130 (ID)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1245764117
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 17, 2017
Last updated in NPPESJune 25, 2020
Certification dateJune 25, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolUNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Graduated 2017 (9 years in practice)
Group practice Emergency Physicians Integrated Care Llc — 203 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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