Dana D Petersen, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

902 Issued in NE

Practice address

7440 S 91St St
Lincoln, NE 68526-9797

Phone

(402) 489-6555

Fax

(402) 328-3770

NPI assigned

Oct 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Nebraska Heart Institute PC

  • Cardiovascular Disease Physician
  • Lincoln, NE
  • NPI 1336125202
  NPD (past)
• North Platte Heart Institute PC

  • Ambulatory Surgical Clinic/Center
  • North Platte, NE
  • NPI 1306058425
  NPD (past)
• The Physician Network

  • Family Medicine Physician
  • Lincoln, NE
  • NPI 1437184652

  Medical

  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1255426524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7440 S 91ST ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269797",
            "telephone_number": "402-489-6555",
            "fax_number": "402-328-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7440 S 91ST ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269797",
            "telephone_number": "402-489-6555",
            "fax_number": "402-328-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "DANA",
        "middle_name": "D",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "902",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026072600",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026072000",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026072500",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200598590A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Storme Peters
• Zachary Michael Peters
• Abigail Petersen
• Ashley E Petersen, PA-C
• Benjamin Brian Petersen, D.P.T.
• Emalie Petersen, RN
• Haeley Brooke Petersen, PT, DPT
• Jaclyn Petersen, MA
• Jacob F Petersen
• Jennifer Suzanne Petersen, RN, IBCLC

• Medical Physician Assistant in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Medical Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.