Cynthia W Peterson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A094853 Issued in IA

Practice address

1801 Hickman Rd
Des Moines, IA 50314-1505

Phone

(515) 282-2200

NPI assigned

Feb 8, 2006

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 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Iowa Pain Management and Medicine Clinic PC

  • Nurse Practitioner
  • West Des Moines, IA
  • NPI 1225083132
  NPD (past)
• Ottumwa Neurological Associates, PC

  • Nurse Practitioner
  • Ottumwa, IA
  • NPI 1588618011
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1285607507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 HICKMAN RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141505",
            "telephone_number": "515-282-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 HICKMAN RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141505",
            "telephone_number": "515-282-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CYNTHIA",
        "middle_name": "W",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A094853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BLUE SHIELD",
            "identifier": "36418",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437244",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cynthiap@gcho.securechart.com",
            "affiliation": "N",
            "endpointDescription": "GCH Clinics",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "401 Audubon St",
            "city": "Adair",
            "state": "IA",
            "country_code": "US",
            "postal_code": "500027708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patricia Jean Petersen, LISW
• Shannon Marie Petersen, P.T.
• Stacey Rae Petersen, NURSE PRACTITIONER
• Peterson Family Dental, PC
• Alicia Peterson, RN
• Eric M Peterson, PHARM.D.
• Evan Douglas Peterson, PA-C
• Gregory E Peterson, D.O.
• Hannah Peterson, DO
• Harold Lars Peterson, LMSW

• Family Nurse Practitioner in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Family Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.