Kirklen Elaine Petersen, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

0116038403 Issued in VA

Practice address

Vcuhs Dept of Anesthesiology Residency
417 N. 11TH St
Richmond, VA 23298-0257

Phone

(804) 828-0733

Fax

(804) 828-8300

NPI assigned

Apr 11, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1184319592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "VCUHS GME ADMINISTRATION",
            "address_2": "PO BOX 980257",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232980257",
            "telephone_number": "804-828-9783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VCUHS DEPT OF ANESTHESIOLOGY RESIDENCY",
            "address_2": "417 N. 11TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232980257",
            "telephone_number": "804-828-0733",
            "fax_number": "804-828-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "KIRKLEN",
        "middle_name": "ELAINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-11",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0116038403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Brady Peterman, MPH, CHES, EP-C
• Jennifer Lynne Peters, PHARMD
• Jesse Silliman Peters
• Lester G Peters, O.D.
• Brittni Ashlan Petersen, LCSW
• Mona Juanita Peterson-Omotola, PH.D. LCPC-AC
• Amity Peterson, DO, PH.D.
• Andrew G Peterson
• Blake Richard Peterson
• Cortney Helen Peterson, FNP-C

• Anesthesiology Physician in Richmond, VA
• Providers in Richmond, VA by specialty
• Anesthesiology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.