Kathleen Ann Peterson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

P31740 Issued in IA

Practice address

530 South 25TH St
Fort Dodge, IA 50501

Phone

(515) 576-2235

Fax

(515) 576-6863

NPI assigned

Apr 12, 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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1437845625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 SOUTH 25TH ST",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "50501",
            "telephone_number": "515-576-2235",
            "fax_number": "515-576-6863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 SOUTH 25TH ST",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "50501",
            "telephone_number": "515-576-2235",
            "fax_number": "515-576-6863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-12",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IA",
            "license": "P31740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Francine Pederson, RD,LD
• Aaron L Peimann, MD
• Mary Elizabeth Pepples, CADC
• Francisco G Peralta, MD
• Adrianne K Peters
• Tammy Jo Peyton, D.P.M.
• Sara Phothisen
• Stephen L Piercy, M.D.
• Planned Parenthood of the Heartland
• Lance T Platt Jr., PHARM.D.

• Licensed Practical Nurse in Fort Dodge, IA
• Providers in Fort Dodge, IA by specialty
• Licensed Practical Nurse in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.