JACOB R PETERSON (NPI# 1235249442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235249442 |
| Entity Type | Individual |
| Full Name | JACOB R PETERSON |
| Credential | AA |
| Practice Address |
1836 South Ave La Crosse WI 54601-5429 |
| Practice Telephone | 6087827300 |
| Mailing Telephone | 6087827300 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2016-03-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367H00000X | Anesthesiologist Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871515593 | Jacob Aaron Peterson | Chiropractor | 434 N Star Rd, Holmen, WI 54636-4402 | 2006-07-24 |
| 1154939262 | Jacob John Peterson | Pharmacist | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2020-07-15 |
| 1720555055 | Jacob Peterson | Registered Nurse | 811 Madison St, Everett, WA 98203-4543 | 2018-10-24 |
| 1295196384 | Jacob Edward Peterson | General Practice | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2016-03-16 |
| 1679954028 | Jacob Christopher Peterson | Family Medicine | 983075 Nebraska Medical Ctr, Unmc Dept. of Family Medicine, Omaha, NE 68198-3075 | 2015-06-11 |
| 1912391475 | Jacob Michael Peterson | Counselor | 7204 Skyway, Paradise, CA 95969-3280 | 2015-03-23 |
| 1841600137 | Jacob Louis Peterson | Case Manager/Care Coordinator | 5667 S Redwood Rd, Taylorsville, UT 84123-5433 | 2014-05-07 |
| Street Address |
1836 SOUTH AVE |
| City | LA CROSSE |
| State | WI |
| Zip Code | 54601-5429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952304834 | Susan G Maclellan-tobert | Pediatrics | 1836 South Ave, La Crosse, WI 54601-5429 | 2005-05-24 |
| 1861099590 | Ellen Compton | Dietitian, Registered | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-10-06 |
| 1699382630 | Jedd Sebion | Pharmacist | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-09-24 |
| 1104436351 | Taryn Jean Simon | Speech-Language Pathologist | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-08-03 |
| 1497376438 | Eva Igler | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-30 |
| 1568083608 | Benjamin Haase Thompson | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-29 |
| 1316568736 | Eric Bobel | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-27 |
| 1134749708 | Kristin Danielle Heslep | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-23 |
| 1982224598 | Rebecca Stanek | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-23 |
| 1609496595 | Marie Gilberte Cineus | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891324265 | Meagan Mcrae | Student in an Organized Health Care Education/Training Program | 1725 State St., 4051 Health Science Center, La Crosse, WI 54601 | 2020-04-07 |
| 1255969671 | Erin Dingman | Student in an Organized Health Care Education/Training Program | 1751 State Street, 4051 Health Science Center, La Crosse, WI 54601 | 2020-03-31 |
| 1619505047 | Nicole Kay Lynch | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State St, La Crosse, WI 54601 | 2020-03-31 |
| 1174151757 | Jenna Sells | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1740818301 | Katie Irene Tahtinen | Student in an Organized Health Care Education/Training Program | Uwl- 4051 Health Science Center, 1725 State St., La Crosse, WI 54601 | 2020-03-30 |
| 1932737517 | Margaret May Grimm | Student in an Organized Health Care Education/Training Program | Univesity of Wisconsin-la Crosse, 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1831727312 | Matthew Timothy Axler | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1093340473 | Denise Stinson | Technician | 1311 Badger St, Apt 505, La Crosse, WI 54601 | 2020-03-06 |
| 1922632397 | Ibrahim Ahsan | Pharmacist | 1105 Wi-16, La Crosse, WI 54601 | 2020-02-25 |
| 1750913356 | Liza R Collins | Massage Therapist | 1415 State Wi 16, La Crosse, WI 54601 | 2020-02-11 |
| Find all providers in zip 54601 | ||||
| Taxonomy Code | 367H00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Anesthesiologist Assistant |
| An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114550985 | Matthew Gene Kopp Baker | Anesthesiologist Assistant | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-02-19 |
| 1629565668 | Steven Robert Hofacker | Anesthesiologist Assistant | 1836 South Ave, La Crosse, WI 54601 | 2018-04-16 |
| 1962910133 | Joseph Matthew Navratil | Anesthesiologist Assistant | 1836 South Ave, La Crosse, WI 54601-5429 | 2018-01-22 |
| 1043760358 | Tia M Morrison | Anesthesiologist Assistant | 1836 South Ave, La Crosse, WI 54601 | 2016-10-11 |
| 1124491998 | Dylan Hartley | Anesthesiologist Assistant | 1836 South Ave, La Crosse, WI 54601-5429 | 2015-11-02 |
| 1417338666 | Emily Gutschenritter | Anesthesiologist Assistant | 1836 South Ave, La Crosse, WI 54601-5429 | 2015-06-13 |
| 1477956894 | Heather Marie Behn | Anesthesiologist Assistant | 1836 South Ave, La Crosse, WI 54601-5429 | 2014-09-30 |
| 1043611320 | Stewart Nicholas Heaton | Anesthesiologist Assistant | 1836 South Ave, La Crosse, WI 54601-5429 | 2014-09-05 |
| 1851641120 | Sarah Ann Harter | Anesthesiologist Assistant | 1836 South Ave, La Crosse, WI 54601-5429 | 2012-09-14 |
| 1093062028 | James Alexander Morrison | Anesthesiologist Assistant | 1836 South Ave, La Crosse, WI 54601-5429 | 2012-08-09 |
| Find all providers in LA CROSSE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.