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

Timothy Peterson, MD

Individual provider Family Medicine Physician · NPI 1922362490

Timothy Peterson, MD is a Family Practice in San Angelo, Texas. Qualified in 2012, 14 years ago. Practices with Shannon Clinic, a 547-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Nevada.

Years since qualifying
14
Licensed in
NV
In the registry since
2012
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

4235 SW Blvd
San Angelo, TX 76904-5635
Phone: (325) 747-1511
Fax: (325) 747-4108
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence LL2279 (NV)

Record details

NPI number1922362490
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 29, 2012
Last updated in NPPESJune 30, 2025
Certification dateJune 30, 2025
Mailing address4235 Southwest Blvd, San Angelo, TX 76904-5635

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Shannon Clinic — 547 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in San Angelo