Katherine A Petersen, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

82882 Issued in GA

Practice address

5354 Reynolds St Ste 202
Savannah, GA 31405-6009

Phone

(912) 352-0920

NPI assigned

Aug 3, 2010

Last updated

Dec 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Metro Surgical, PC

  • Surgery Physician
  • Rincon, GA
  • NPI 1902823024
  Medicare reassignment NPD
• Taylor Regional Hospital

  dba Taylor Physicians Practice # 22

  • Surgery Physician
  • Hawkinsville, GA
  • NPI 1245662527
  NPD
• Metro Surgical PC

  • Surgery Physician
  • Bluffton, SC
  • NPI 1033481551
  NPD

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1508170457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313260919",
            "telephone_number": "912-352-0920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5354 REYNOLDS ST STE 202",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056009",
            "telephone_number": "912-352-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "KATHERINE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-03",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "82882",
            "primary": true
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "KY",
            "license": "48313",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alfred E Pesto Jr., DMD
• Pet Imaging Center of Savannah LLC (Trident PET of Savannah)
• Renny Valamparambil Peter, M.D
• Ellaree Yvette Peters
• Geoffrey Peters, M.D.
• Jakeshia Lynette Peterson
• Hillary Sinclair Petnuch, APRN, CPNP-PC
• Guy J. Petruzzelli, MD, PHD
• Kimberly Pettiford
• Carmela Amelia Pettigrew, MD

• Surgery Physician in Savannah, GA
• Providers in Savannah, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.