Lisa Peterson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601005897 Issued in MI

Practice address

1500 E Sherman Blvd
Muskegon, MI 49444-1849

Phone

(231) 739-9341

NPI assigned

Sep 23, 2010

Last updated

Feb 24, 2011By the provider in NPPES

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 names 1

• Lisa Tovey Former name

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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

• Lake Michigan Emergency Specialists, PLLC

  • Emergency Medicine Physician
  • Muskegon, MI
  • NPI 1124574520
  Medicare reassignment
• Emergency Health Partners Muskegon

  • Emergency Medicine Physician
  • Muskegon, MI
  • NPI 1235179029
  NPD (past)

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298505600000",
    "number": "1144538133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 673397",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482673397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441849",
            "telephone_number": "231-739-9341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "LISA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-23",
        "last_updated": "2011-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "TOVEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bill Perry
• Michelle Perry
• Richard William Peters, M.D.
• Devan William Allan Peterson, RN
• Kelly Malia Peterson, PA-C
• Lynn Marie Peterson, RPH
• Soaries Maxine Peterson, PH.D., M.D.
• Alicia Petty
• Veronica R Petty, M.D.
• Jessica Lynn Pfeil

• Physician Assistant in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.