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JENNIFER C PETERSON M.D. NPI 1154586071


NPI Information

NPI: 1154586071
Provider Name: JENNIFER C PETERSON, M.D.
Classification: Pediatrics - 2080P0203X
Entity Type: Individual

Specialization: Pediatric Critical Care Medicine

PECOS Registration: Yes

Address:
1836 SOUTH AVE
LA CROSSE, WI
ZIP 54601
Phone: (608) 782-7300
Get Directions

Jennifer C Peterson, M.D. is a pediatric critical care medicine pediatrics in La Crosse, WI. The provider is a pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. Jennifer C Peterson, M.D. NPI is 1154586071. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1836 SOUTH AVE
LA CROSSE, WI
ZIP 54601-429
Phone: (608) 782-7300

The NPI 1154586071 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/21/2008 and was last updated on 7/31/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080P0203XPediatricsPediatric Critical Care Medicine13205NORTH DAKOTANo
22080P0203XPediatricsPediatric Critical Care Medicine075484GEORGIANo
32080P0203XPediatricsPediatric Critical Care Medicine71077ARIZONANo
4390200000XStudent in an Organized Health Care Education/Training ProgramNo
52080P0203XPediatricsPediatric Critical Care Medicine53734WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
181315MEDICAIDNORTH DAKOTA
2PENDINGMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.