Vagn Petersen, MS, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

14222 Issued in CA

Practice address

1001 Potrero Avenue, Suite 3a
SFGH - Trauma Surgery Service
San Francisco, CA 94110

Phone

(415) 206-4073

NPI assigned

Nov 7, 2006

Sex

Male

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 CA

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

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• City & County of San Francisco

  dba San Francisco Public Health Laboratory

  • Clinical Medical Laboratory
  • San Francisco, CA
  • NPI 1982737524
  Medicare reassignment NPD
• City & County of San Francisco

  dba CCSF DPH Multi - Practice Medical Group

  • Community Health/Public Health Clinical Nurse Specialist
  • San Francisco, CA
  • NPI 1609041060

  Acute Care

  NPD
• City and County of San Francisco

  dba DSAAM OTOP Methadone Maintenance

  • Methadone Clinic
  • San Francisco, CA
  • NPI 1578787925
  NPD

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437228855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 ALABAMA ST",
            "address_2": "UNIT 101",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94110",
            "telephone_number": "415-282-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVENUE, SUITE 3A",
            "address_2": "SFGH - TRAUMA SURGERY SERVICE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94110",
            "telephone_number": "415-206-4073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "VAGN",
        "credential": "MS, NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "14222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Paul Petersen
• Dana Kristopher Petersen, MD
• Heather Petersen, DPT
• Karla Melissa Petersen, M.D.
• Mark Alan Petersen, M.D.
• Alissa Marie Peterson, M.D.
• Amy Hope Peterson, MFT
• Andrew Nelson Peterson
• Anja Peterson
• Anna Marie Peterson

• Acute Care Nurse Practitioner in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.