NPIMap

Individual provider Active NPI

Danelle Catherine Peterson, PA-C

  • Physician Assistant
  • Council Bluffs, IA
National Provider Identifier
1679807796
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
073995 Issued in IA
Practice address
1288 Valley View Dr
Council Bluffs, IA 51503-5245
Phone
(712) 328-8800
Fax
(712) 328-8461
NPI assigned
Sep 22, 2009
Last updated
Dec 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1463 NE
Physician Assistant 363A00000X 073995 IA Primary

Addresses

Primary practice location

1288 Valley View Dr
Council Bluffs, IA 51503-5245

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091028000724 NE Practitioner - Physician Assistant 7214074962 Reassigns benefits to 4 organizations
I20140811000205 IA Practitioner - Physician Assistant 7214074962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Think Aksarben LLCGroup PAC ID 9638394505, 77 clinicians

Practice addresses (Care Compare)

7100 W Ctr Rd
Omaha, NE 68106-2714
Phone (402) 506-9000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1463NEMDCounselor
073995IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Health Memorial Hospital, Schuyler CurrentSince Sep 28, 2009 Accepting new patients
Alegent Health Memorial Hospital, Schuyler CurrentSince Jan 1, 2025 Accepting new patients
Alegent Creighton Clinic Physician Assistant CurrentSince Jul 10, 2014 Accepting new patients
Alegent Health Memorial Hospital Schuyler CurrentSince Sep 28, 2009 Accepting new patients

Locations

800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

104 W 17th St
Schuyler, NE 68661
Phone (402) 352-2441

1721 Colfax St
Schuyler, NE 68661
Phone (402) 352-3745

Interoperability endpoints

  • Direct secure messaging: danellepeterson@thinkaks.allscriptsdirect.net
  • Direct secure messaging: dpeterson8623@achce.catholichealth.net

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

Hospital & facility affiliations 3

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": "1253577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1679807796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1288 VALLEY VIEW DR",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515035245",
            "telephone_number": "712-328-8800",
            "fax_number": "712-328-8461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DANELLE",
        "middle_name": "CATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-22",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1463",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "073995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.