Active NPI
Fielding Petersen Dunn, PA-C
- Medical Physician Assistant
- Salt Lake City, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 8695219-1206
- Practice address
- 117 W 400 S
Salt Lake City, UT 84101-1916 - Phone
- (801) 428-4257
- NPI assigned
- Aug 12, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 8695219-1206 | UT | Primary |
Addresses
Primary practice location
117 W 400 S
Salt Lake City, UT 84101-1916
Mailing address
117 W 400 S
Salt Lake City, UT 84101-1916
Phone (801) 428-4257
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Wake Forest University School of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
115 E Ogden Ave
Naperville, IL 60563-3103
520 Rose LN
Wickenburg, AZ 85390-1447
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8695219-1206 | UT | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Hospital Association, Inc. | Current | Accepting new patients | |
| Allred Psychological Services | Past | Accepting new patients | |
| Granger Medical Clinic PC | Past | Accepting new patients | |
| Kelly Wosnik Inc | Past | Accepting new patients | |
| Community Hospital Association, Inc. | Past | Accepting new patients | |
| Ogden Internal Medicine & Urology LLC | Past | Accepting new patients |
Locations
523 Rose Ln
Wickenburg, AZ 85390
Phone (928) 668-1833
520 Rose Ln
Wickenburg, AZ 85390
Phone (928) 666-1197
1395 W Wickenburg Way
Ste A
Wickenburg, AZ 85390
32919 N Center St
Wittmann, AZ 85361
Phone (928) 668-1833
Organizations & group practices 6
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.
-
- Critical Access Hospital
- Wickenburg, AZ
- NPI 1841282852
-
- Clinical Psychologist
- Orem, UT
- NPI 1720512270
-
- Multi-Specialty Clinic/Center
- West Valley City, UT
- NPI 1184657041
-
- Clinic/Center
- Orem, UT
- NPI 1346549060
-
- Internal Medicine Physician
- Ogden, UT
- NPI 1003001553
-
- Rural Health Clinic/Center
- Wickenburg, AZ
- NPI 1225274210
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734307200000",
"number": "1528491735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 W 400 S",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841011916",
"telephone_number": "801-428-4257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 W 400 S",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841011916",
"telephone_number": "801-428-4257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNN",
"first_name": "FIELDING",
"middle_name": "PETERSEN",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-08-12",
"last_updated": "2024-12-16",
"certification_date": "2024-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "UT",
"license": "8695219-1206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.