JESSICA MARIE PETERSEN (NPI# 1699167254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699167254 |
| Entity Type | Individual |
| Full Name | JESSICA MARIE PETERSEN |
| Credential | PA-C |
| Practice Address |
500 Foothill Dr Dept of Holistic Medicine Salt Lake City UT 84148-0001 |
| Practice Telephone | 8015821565 |
| Enumeration Date | 2015-02-19 |
| Last Update Date | 2015-02-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821393745 | Jessica Petersen | Physical Therapy Assistant | 8550 S 300 E Apt 3, Sandy, UT 84070-1676 | 2011-01-25 |
| 1831738517 | Jessica Lee Petersen | Registered Nurse | 3001 Maple Rd, Slayton, MN 56172-4500 | 2019-12-30 |
| 1548621279 | Jessica Petersen | Dietitian, Registered | 1660 S Columbian Way, S-120-nfs, Seattle, WA 98108-1532 | 2016-03-08 |
| 1902128887 | Jessica Lanier Petersen | Pharmacist | 1310 S Cannon Blvd, Kannapolis, NC 28083-6233 | 2010-02-19 |
| 1346480324 | Jessica Rae Petersen | Chiropractor | 4907 W 95th St, Oak Lawn, IL 60453-2503 | 2009-03-03 |
| 1629041439 | Jessica L Petersen | Occupational Therapist | 200 1st St Sw, Rochester, MN 55905-0001 | 2006-02-10 |
| Street Address |
500 FOOTHILL DR DEPT OF HOLISTIC MEDICINE |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84148-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700889011 | Anthony W Middleton Jr. | Specialist | 500 Foothill Dr, Surgery (urology), Salt Lake City, UT 84148-0001 | 2005-05-31 |
| 1376150953 | Annette Sprankle | Pharmacist | 500 Foothill Dr, Salt Lake City, UT 84148-0001 | 2020-09-28 |
| 1912512559 | Taylor Nicole Schweitzer | Speech-Language Pathologist | 500 Foothill Dr, Salt Lake City, UT 84148-0001 | 2020-09-10 |
| 1134733421 | Cord Speck | Nurse Practitioner | 500 Foothill Dr, Salt Lake City, UT 84148-0001 | 2020-09-03 |
| 1023621232 | Thomas Alan Good Lance White Bull | Pharmacy Technician | 500 Foothill Dr, Salt Lake City, UT 84148-0001 | 2020-08-26 |
| 1376155606 | Cassie Dance | Psychologist | 500 Foothill Dr, Salt Lake City, UT 84148-0001 | 2020-08-18 |
| 1255943734 | Julia Ann Packard | Registered Nurse | 500 Foothill Dr, Salt Lake City, UT 84148-0001 | 2020-08-17 |
| 1558972729 | Kathleen Sarette | Nurse Practitioner | 500 Foothill Dr, Salt Lake City, UT 84148-0001 | 2020-08-12 |
| 1154931723 | Peter Jerome Torcivia | Student in an Organized Health Care Education/Training Program | 500 Foothill Dr, Salt Lake City, UT 84148-0001 | 2020-08-07 |
| 1184234262 | Rebecca E Montgomery | Student in an Organized Health Care Education/Training Program | 500 Foothill Dr, Salt Lake City, UT 84148-0001 | 2020-08-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598211799 | Jacquelyn Rae Contant | Dietitian, Registered | 500 Foothill Dr. (120), Salt Lake City, UT 84148 | 2016-08-28 |
| 1699127811 | Taylor Alford | Pharmacist | 500 Foothills Drive, Salt Lake City, UT 84148 | 2016-07-12 |
| 1356792162 | Sarah Hummel | Genetic Counselor, MS | 500 Foothill Drive, Sarah Hummel, Va Salt Lake City, Genomic Medicine (10p4e), Salt Lake City - Salt Lake, UT 84148 | 2016-06-23 |
| 1174936140 | Elizabeth Shade Cardenas | Nurse Practitioner | 500 Foothill Drive #182h, Veterans Healthcare Administration, Salt Lake City, UT 84148 | 2014-06-08 |
| 1386904043 | David Earl Moore | Specialist | 500 Foothill Blvd (research), George E. Wahlen Va Healthcare System, Salt Lake City, UT 84148 | 2012-05-29 |
| 1790059038 | Deborah Ernstein Holley Hartzfeld | Genetic Counselor, MS | 615 Arapeen Drive #212, Salt Lake City, UT 84148 | 2012-03-05 |
| 1073823720 | Diana Lynn Robbins | Social Worker | 9140 W. Post Road, Las Vegas, NV 84148 | 2010-10-15 |
| 1659534394 | Katherine Margaret Dunn | Genetic Counselor, MS | 500 Foothill Drive (151z), Salt Lake City, UT 84148 | 2008-07-02 |
| 1730381625 | Douglas James Ball | Medical Genetics | Va Salt Lake City Health Care System 10p11, Salt Lake City, UT 84148 | 2007-06-03 |
| 1245339530 | Daniel H Priestly | Radiology | 500 Foothill Dr., Salt Lake City, UT 84148 | 2006-09-22 |
| Find all providers in zip 84148 | ||||
| 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 |
|---|---|---|---|---|
| 1417556986 | Brittany Tran | Physician Assistant | 2733 W Redwick Ct, Salt Lake City, UT 84129-5901 | 2020-10-25 |
| 1528674975 | James Christopher Nichols | Physician Assistant | 1746 E 2100 S, Salt Lake City, UT 84106-4165 | 2020-09-21 |
| 1841826971 | David Souza | Physician Assistant | 52 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-03-20 |
| 1134751902 | Jacie Anna Mundahl | Physician Assistant | 8th Ave C St E 80, Salt Lake City, UT 84143-0001 | 2020-02-10 |
| 1336770544 | Kelsey Rae Thompson | Physician Assistant | 3809 S Parkview Dr, Salt Lake City, UT 84124-2322 | 2020-01-28 |
| 1245885458 | Adam Douglas Whitney | Physician Assistant | 1056 E Harrison Ave, Salt Lake City, UT 84105-2445 | 2019-08-05 |
| 1306498654 | Jarred J Entringer | Physician Assistant | 2725 S 700 E Apt K, Salt Lake City, UT 84106-2883 | 2019-07-16 |
| 1588216840 | Christina Thomas | Physician Assistant | 255 N 400 W Apt 5015, Salt Lake City, UT 84103-1568 | 2019-07-16 |
| 1770135022 | Evar Saelee | Physician Assistant | 2630 E Stringham Ave Apt 224a, Salt Lake City, UT 84109-3945 | 2019-07-16 |
| 1982263471 | Ashley Marten | Physician Assistant | 3610 E Cascade Way, Salt Lake City, UT 84109-2307 | 2019-06-10 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84148 |
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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.