Center for Plastic Surgery, PA

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

CENTER FOR PLASTIC SURGERY, PA

Practice address

631 SW Horne St
Suite 400
Topeka, KS 66606-1694

Phone

(785) 234-9000

Fax

(785) 234-9119

NPI assigned

Nov 24, 2009

Last updated

Nov 24, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jack Tellin Peterson Jr., MDNPI 1508860487

Title

Ceo

Phone

(785) 234-9000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jack T Peterson Jr., MD

  • Specialist
  • Topeka, KS
  • NPI 1508860487
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259020800000",
    "number": "1457689770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 SW HORNE ST",
            "address_2": "SUITE 400",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666061694",
            "telephone_number": "785-234-9000",
            "fax_number": "785-234-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 SW HORNE ST",
            "address_2": "SUITE 400",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666061694",
            "telephone_number": "785-234-9000",
            "fax_number": "785-234-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PLASTIC SURGERY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-24",
        "last_updated": "2009-11-24",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "TELLIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "785-234-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Caylor, CPTA
• CBW Therapy LLC (CBW Therapy)
• Center for Advanced Gynecology Revocable Trust
• Center for Manual Medicine, P.a. (The Center for Manual Medicine)
• Center for Nutrition and Preventive Medicine
• Center for Sight of Northeast Kansas, PA (Heartland Eye Care)
• Pablo A Cerca
• Cerebral Medical Group, P.a.
• CFCC & Associates, Inc.
• Andrea L Chaffee

• Plastic and Reconstructive Surgery Physician in Topeka, KS
• Providers in Topeka, KS by specialty
• Plastic and Reconstructive Surgery Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.