NPIMap

Individual provider Active NPI

Jordan Dane Peterson, M.D.

  • Internal Medicine Physician
  • West Des Moines, IA
National Provider Identifier
1306228366
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD-44443 Issued in IA
Practice address
6000 University Ave Ste 300
West Des Moines, IA 50266-8200
Phone
(515) 241-2400
Fax
(515) 241-2401
NPI assigned
Jun 25, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD-44443 IA Primary

Addresses

Primary practice location

6000 University Ave Ste 300
West Des Moines, IA 50266-8200

Mailing address

6000 University Ave Ste 300
West Des Moines, IA 50266-8200
Phone (515) 241-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180712001233 IA Practitioner - Internal Medicine 4284947094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Iowa, RJ & L Carver College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

6000 University Ave
Suite 300
West Des Moines, IA 50266-8200
Phone (515) 241-2400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation Internal Medicine CurrentSince Sep 4, 2018 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

1415 Woodland Ave
Ste 140
Des Moines, IA 50309
Phone (515) 241-4076

8101 Birchwood Ct
Unit R
Urbandale, IA 50131
Phone (515) 471-9363

6000 University Ave
Ste 300
West Des Moines, IA 50266
Phone (515) 241-2250

Interoperability endpoints

  • Direct secure messaging: jpeterson147119@direct.unitypoint.org

Organizations & group practices 2

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1306228366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 UNIVERSITY AVE STE 300",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668200",
            "telephone_number": "515-241-2400",
            "fax_number": "514-241-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 UNIVERSITY AVE STE 300",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668200",
            "telephone_number": "515-241-2400",
            "fax_number": "515-241-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JORDAN",
        "middle_name": "DANE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-25",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "MD-44443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.