Shalena Peterson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

8594 Issued in AZ

Practice address

3120 Clearwater Dr
Prescott, AZ 86305-7131

Phone

(928) 771-3704

Fax

(928) 771-0434

NPI assigned

Sep 24, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN, AZ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Yavapai Regional Medical Center Physician Care LLCGroup PAC ID 5294898987, 123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Yavapai Regional Medical Center Physician Care LLC

  • Cardiovascular Disease Physician
  • Prescott, AZ
  • NPI 1255582003
  Medicare reassignment Care Compare group
• Arizona Emergency Medicine Specialists PC

  • Emergency Medicine Physician
  • Lake Havasu City, AZ
  • NPI 1134439706
  Medicare reassignment
• Tri-Cities Observation Services, PC

  • Emergency Medicine Physician
  • Johnson City, TN
  • NPI 1154860146
  Medicare reassignment
• Tri-Cities Regional Emergency Physicians, PC

  • Emergency Medicine Physician
  • Johnson City, TN
  • NPI 1063950046
  Medicare reassignment
• Yavapai Regional Medical Center Physician Care LLC

  • Internal Medicine Physician
  • Prescott, AZ
  • NPI 1083940399
  NPD
• Yavapai Regional Medical Center Physician Care LLC

  • Cardiovascular Disease Physician
  • Prescott, AZ
  • NPI 1528394830
  NPD
• Appalachian Emergency Physicians

  • Emergency Medicine Physician
  • Erwin, TN
  • NPI 1932451291
  NPD
• Prescott Gastroenterology

  • Gastroenterology Physician
  • Prescott, AZ
  • NPI 1720110984
  NPD (past)
• State of Franklin Healthcare Associates PLLC

  • Clinical Medical Laboratory
  • Johnson City, TN
  • NPI 1841846136
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Yavapai Community Hospital Association

  • General Acute Care Hospital
  • Prescott, AZ
  • NPI 1902897820
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1083965651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10880",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 CLEARWATER DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057131",
            "telephone_number": "928-771-3704",
            "fax_number": "928-771-0434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SHALENA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-24",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "8594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "097887",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Becky Ann Peterson, OTR
• Brek Lamont Peterson, P.T.
• Hannah B Peterson, RDH
• Kent Lee Peterson, D.P.M.
• Sarah Peterson, DPT
• Sharla J. Peterson, OTR
• Spencer Girard Peterson
• Trent M Peterson, DO
• Holly Susan Pfau, PT, DPT
• Paul Christian Pflueger, MD

• Medical Physician Assistant in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.