MR. SCOTT D. PETERSEN (NPI# 1689640948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689640948 |
| Entity Type | Individual |
| Full Name | MR. SCOTT D. PETERSEN |
| Credential | PA-C |
| Practice Address |
33300 Cleveland Clinic Blvd Mail Code Avh4-143 Avon OH 44011 |
| Practice Telephone | 4406955449 |
| Mailing Telephone | 4406955449 |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2016-11-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 0010-02841 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 85000637 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363A00000X | Physician Assistant | 50.002138 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922420082 | Scott Petersen | Counselor | 625 N Plaza Dr, Apache Junction, AZ 85120-5501 | 2014-01-09 |
| 1346561966 | Scott Petersen | Counselor | 757 S Main St, Springville, UT 84663-2452 | 2010-06-17 |
| 1295931046 | Scott William Petersen | Dentist | 310 N 400 E, Nephi, UT 84648-1558 | 2007-06-26 |
| 1710034251 | Scott J. Petersen | General Practice | 275 W Macarthur, Oakland, CA 94611-5641 | 2007-01-05 |
| 1386758183 | Scott R Petersen | Social Worker | 2111 Champa St, Denver, CO 80205-2529 | 2006-08-18 |
| 1275574519 | Scott Martin Petersen | Obstetrics & Gynecology | 2150 Pennsylvania Ave Nw, Washington, DC 20037-3201 | 2006-06-09 |
| 1912986555 | Scott Richard Petersen | Surgery | 500 W Thomas Rd, Suite 400, Phoenix, AZ 85013-4224 | 2006-01-12 |
| Street Address |
33300 CLEVELAND CLINIC BLVD MAIL CODE AVH4-143 |
| City | AVON |
| State | OH |
| Zip Code | 44011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023657780 | Fallon Marlene Ferrari | Physician Assistant | 33300 Cleveland Clinic Blvd, Avon, OH 44011-1172 | 2019-12-29 |
| 1386205615 | Christopher John Ranc | Physician Assistant | 33300 Cleveland Clinic Blvd, Avon, OH 44011-1172 | 2019-06-26 |
| 1902369135 | Ashley Carolyn Portale | Physician Assistant | 33300 Cleveland Clinic Blvd, Avon, OH 44011-1172 | 2019-04-14 |
| 1598223729 | Christina Marie Watkins | Nurse Practitioner | 33300 Cleveland Clinic Blvd, Avon, OH 44011-1172 | 2019-03-06 |
| 1699248187 | Moriah Buckley Jamison | Physician Assistant | 33300 Cleveland Clinic Blvd, Avon, OH 44011-1172 | 2019-01-07 |
| 1316419013 | Ela Mici | Nurse Practitioner | 33300 Cleveland Clinic Blvd, Avon, OH 44011-1172 | 2018-12-19 |
| 1235613001 | Krystal Ashley Schmitt | Nurse Practitioner | 33300 Cleveland Clinic Blvd, Avon, OH 44011-1172 | 2018-09-18 |
| 1881173912 | Erica Barb | Nurse Practitioner | 33300 Cleveland Clinic Blvd, Avon, OH 44011-1172 | 2018-08-09 |
| 1477092625 | Alexis Dobbs | Physician Assistant | 33300 Cleveland Clinic Blvd, Avon, OH 44011-1390 | 2017-02-21 |
| 1063957769 | Linda Bartko | Nurse Practitioner | 33300 Cleveland Clinic Blvd, Avon, OH 44011-5733 | 2017-01-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750845889 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 1810 Nagel Rd, Avon, OH 44011 | 2019-01-23 |
| 1548758782 | Stacey L Yanetta | Social Worker | Avon-richard E. Jacobs Health Center, 33100 Cleveland Clinic Blvd, Avon, OH 44011 | 2018-04-24 |
| 1073054540 | Timothy Weitzel | Social Worker | 36419 Edenhall Terrace, Avon, OH 44011 | 2017-03-16 |
| 1568829059 | Jessica Ryan Springer | Nurse Practitioner | 36130 N Park Dr, Avon, OH 44011 | 2016-01-28 |
| 1962879569 | Cleveland Clinic Rehabilitation Hospitals, LLC | Rehabilitation Hospital | 33355 Health Campus Boulevard, Avon, OH 44011 | 2015-08-31 |
| 1619373024 | Avon Healthcare Center, Inc. | Skilled Nursing Facility | 37845 Colorado Avenue, Avon, OH 44011 | 2014-11-12 |
| 1508272543 | Samantha Willi | Counselor | 37040 Colorado Ave, Avon, OH 44011 | 2014-07-10 |
| 1336572791 | Todd Bernard | Dentist | 37701 Colorado Ave Ste E, Avon, OH 44011 | 2013-08-20 |
| 1245550730 | Kenneth Charles Hohmeier | Pharmacist | 38530 Chester Road, Suite 400, Avon, OH 44011 | 2010-06-07 |
| 1760712343 | Avon Local School District | Local Education Agency (LEA) | 36600 Detroit Road, Avon, OH 44011 | 2010-01-05 |
| Find all providers in zip 44011 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831702570 | Nathan Dean Hailey | Physician Assistant | 1115 Ronald Reagan Pkwy Ste 247, Avon, IN 46123-6911 | 2020-08-24 |
| 1841848298 | Kayla Nichole Kawiecki | Physician Assistant | 2351 Chelsea St, Avon, OH 44011-5227 | 2019-08-29 |
| 1831591791 | Michael Czajka | Physician Assistant | 33100 Cleveland Clinic Blvd # 2-2, Avon, OH 44011-1390 | 2014-09-23 |
| 1043558596 | Kelly L Foutch | Physician Assistant | 8607 E Us Highway 36 Ste 300, Avon, IN 46123-7960 | 2013-01-17 |
| 1215291943 | Mari E. Friedman | Physician Assistant | 1115 Ronald Reagan Pkwy Ste 348, Avon, IN 46123 | 2012-06-27 |
| 1346523636 | Amanda Duncan | Physician Assistant | 33100 Cleveland Clinic Blvd # 2-1, Avon, OH 44011-1390 | 2011-09-22 |
| 1134376304 | Katherine B Bares | Physician Assistant | 8 Canal Ct, Avon, CT 06001-3726 | 2008-08-19 |
| 1205059185 | Peter J. Dolan | Physician Assistant | 2077 Lakeville Rd, Suite 3, Avon, NY 14414 | 2007-04-10 |
| 1467459206 | Don Armenoff | Physician Assistant | 8244 E Us Highway 36 Ste 1100, Avon, IN 46123-9627 | 2005-07-07 |
| 1467052217 | Elizabeth M Larned | Physician Assistant | 385 W Main St, Avon, CT 06001-4357 | 2020-10-30 |
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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.