Peggy S Peterson, D.O.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

0518987 Issued in KS

Practice address

1133 College Ave
Manhattan, KS 66502-2770

Phone

(785) 539-5363

Fax

(785) 539-5862

NPI assigned

Aug 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: peggy.peterson@khindirect.org

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330992000000",
    "number": "1861400301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 COLLEGE AVE",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665022770",
            "telephone_number": "785-539-5363",
            "fax_number": "785-539-5862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 COLLEGE AVE",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665022770",
            "telephone_number": "785-539-5363",
            "fax_number": "785-539-5862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "PEGGY",
        "middle_name": "S",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2012-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KS",
            "license": "0518987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "220020955",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000162020A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clark Allen Petersen, D.C.
• Peterson Laboratory Services, PA
• Peterson Laboratory Services, PA
• Jennifer Peterson, APRN-C
• Katherine K Peterson, SLP
• Victoria J Pettay
• Kelli Renae Pettijohn
• Britney Petty, RD LD
• Terry Pfannenstiel, LCMFT
• Emma Pfizenmaier

• Anatomic Pathology & Clinical Pathology Physician in Manhattan, KS
• Providers in Manhattan, KS by specialty
• Anatomic Pathology & Clinical Pathology Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.