NPIMap

Individual provider Active NPI

Judith R Peterson, MD

  • Physical Medicine & Rehabilitation Physician
  • Yankton, SD
National Provider Identifier
1629080346
Registry record updated Jun 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
5238 Issued in SD
Practice address
1104 W 8TH St
Yankton, SD 57078-3306
Phone
(605) 665-7841
Fax
(605) 665-0546
NPI assigned
Aug 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 5238 SD Primary

Addresses

Primary practice location

1104 W 8TH St
Yankton, SD 57078-3306

Mailing address

1104 W 8TH St
Yankton, SD 57078-3306
Phone (605) 665-7841

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address judith.peterson@direct.yanktonmedicalclinic.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040317000951 SD Practitioner - Physical Medicine and Rehabilitation 6305734948 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
JS Weill Medical College, Cornell University, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yankton Medical Clinic PCGroup PAC ID 1850208778, 59 clinicians
Sacred Heart Health ServicesGroup PAC ID 6103729066, 151 clinicians

Practice addresses (Care Compare)

1104 W 8TH St
Yankton, SD 57078-3306
Phone (605) 665-7841

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5238SDMDPhysical Medicine & Rehabilitation Physician
0416SDMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health Services CurrentSince Jan 1, 2026 Accepting new patients
Sacred Heart Health Services CurrentSince Jan 1, 2026 Accepting new patients
Yankton Medical Clinic PC Current Accepting new patients
Yankton Medical Clinic PC CurrentSince Jan 21, 2013 Accepting new patients
Yankton Medical Clinic PC Current Accepting new patients
Yankton Medical Clinic PC CurrentSince Jan 21, 2013 Accepting new patients
Sacred Heart Health Services Past Accepting new patients

Locations

1104 W 8th St
Yankton, SD 57078
Phone (605) 665-7841

501 Summit St
Yankton, SD 57078
Phone (605) 655-1201

Interoperability endpoints

  • Direct secure messaging: judith.peterson@direct.yanktonmedicalclinic.nextgenshare.com

Organizations & group practices 7

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1629080346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 W 8TH ST",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570783306",
            "telephone_number": "605-665-7841",
            "fax_number": "605-665-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 W 8TH ST",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570783306",
            "telephone_number": "605-665-7841",
            "fax_number": "605-665-0546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JUDITH",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "SD",
            "license": "5238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "judith.peterson@direct.yanktonmedicalclinic.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1104 W 8th St",
            "city": "Yankton",
            "state": "SD",
            "country_code": "US",
            "postal_code": "570783306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Yankton, SD

Sources for this page

Verify at the official NPI Registry.