Devin Faye Petersen

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

IN PROCESS Issued in UT

Practice address

2995 E Middleton Way
SLC, UT 84124-3055

Phone

(801) 597-6419

NPI assigned

Sep 1, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

State licenses

Practice roles

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.

• Exodus Healthcare Network PLLC

  • Family Medicine Physician
  • Magna, UT
  • NPI 1306952783
  Medicare reassignment
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment
• Ihc Health Services Inc

  • Cardiovascular Disease Physician
  • Mt Pleasant, UT
  • NPI 1396990883
  NPD

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1154878692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 E MIDDLETON WAY",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841243055",
            "telephone_number": "801-597-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2995 E MIDDLETON WAY",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841243055",
            "telephone_number": "801-597-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "DEVIN",
        "middle_name": "FAYE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "IN PROCESS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodney Santos Perman I
• Amber S Perry, PT
• Daphne Anne Perry, PT
• Gabrielle Christina Persons
• Megan Jill Peters
• Cynthia M Peterson, SLP
• Jeff Hale Pettey, MD
• Savanah Miriah Pettigrew
• Amber Mathiesen Phillips, MS
• Andrew Luke Phillips, M.D

• Medical Physician Assistant in SLC, UT
• Providers in SLC, UT by specialty
• Medical Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.