DR. JILL M PETERSON (NPI# 1669695136) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669695136 |
| Entity Type | Individual |
| Full Name | DR. JILL M PETERSON |
| Credential | PSYD |
| Practice Address |
3801 Spring St Racine WI 53405-1667 |
| Mailing Address |
410 West Blvd Racine WI 53405-2147 |
| Practice Telephone | 2626878538 |
| Practice Fax Number | 2626874334 |
| Mailing Telephone | 2626878538 |
| Mailing Fax Number | 2626874334 |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2008-12-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
2709057 | WI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134654478 | Jill Peterson | Occupational Therapist | 914 S Jefferson St, Apt. 1, Moscow, ID 83843-3163 | 2017-04-24 |
| 1487977906 | Jill A Peterson | Pharmacist | 47-49 Lake Ave. Extension, Danbury, CT 06810 | 2010-03-11 |
| 1922153931 | Jill Ann Peterson | Psychologist | 520 N Broad St # 1, Mankato, MN 56001-3421 | 2007-01-23 |
| 1861562274 | Jill C Peterson | Psychologist | 6600 Kalanianaole Hwy., Suite 225, Honolulu, HI 96825 | 2006-11-09 |
| 1356379739 | Jill Peterson | Dentist | 906 N Fielder Rd, Arlington, TX 76012-3195 | 2006-06-28 |
| 1629074232 | Jill Christine Peterson | Emergency Medicine | 622 Washington St, Comprehensive Womens Health Services, Watertown, NY 13601-4036 | 2005-06-28 |
| 1144529850 | Jill Anne Peterson | Nurse Practitioner | 55 Fruit St, Warren 11 - Pediatric Surgery, Boston, MA 02114-2621 | 2011-03-21 |
| 1700107612 | Jill Peterson | Specialist | 6125 N Sunshine St, Coeur D Alene, ID 83815 | 2010-06-15 |
| 1134203326 | Jill M Peterson | Family Medicine | 602 N Main St, Summerville, SC 29483-6627 | 2006-10-24 |
| Street Address |
3801 SPRING ST |
| City | RACINE |
| State | WI |
| Zip Code | 53405-1667 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033115787 | Mark A. Pelton | Pharmacist | 3801 Spring St, Racine, WI 53405-1667 | 2005-06-27 |
| 1528685252 | Tanya Higgins | Nurse Anesthetist, Certified Registered | 3801 Spring St, Racine, WI 53405 | 2020-06-29 |
| 1033583190 | Jennifer Scidmore | Physician Assistant | 3801 Spring St, Racine, WI 53405 | 2015-11-30 |
| 1265774715 | Erin Cecelia Siegel | Internal Medicine | 3801 Spring St, Racine, WI 53405 | 2013-03-22 |
| 1578866448 | Courtney Brooke Hoffman | Nurse Anesthetist, Certified Registered | 3801 Spring St, Racine, WI 53405-1667 | 2010-12-14 |
| 1740595032 | Renate A Villarreal | Physician Assistant | 3801 Spring St, Racine, WI 53405-1667 | 2010-08-11 |
| 1669784112 | Peter David Blochowicz | Nurse Anesthetist, Certified Registered | 3801 Spring St, Racine, WI 53405-1667 | 2010-07-12 |
| 1154651115 | Jeffrey Thomas Vaughan Kroeger | Nurse Anesthetist, Certified Registered | 3801 Spring St, Racine, WI 53405-1667 | 2010-01-13 |
| 1467782748 | Racine Anesthesia Services, LLC | Nurse Anesthetist, Certified Registered | 3801 Spring St, Racine, WI 53405-1667 | 2010-01-08 |
| 1104058528 | Matthew T Czerniak | Physician Assistant | 3801 Spring St, Racine, WI 53405-1667 | 2009-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609407923 | Anita Kathy Nykaza | Dietitian, Registered | 3805 A Suite 311, Racine, WI 53405 | 2020-01-27 |
| 1023666062 | Shawn L Drulia | Physician Assistant | 3805 Spring St #320, Racine, WI 53405 | 2019-09-03 |
| 1235627720 | Oxygen One, Inc. | Durable Medical Equipment & Medical Supplies | 3805a Spring Street, Suite 210, Racine, WI 53405 | 2018-04-30 |
| 1356838650 | Melissa Metzger | Psychologist | 2340 Mohr Ave, Racine, WI 53405 | 2018-04-23 |
| 1689029217 | Melissa Ileen Swainston | Nurse Practitioner | 3803 Spring St., Suite Number 410, Racine, WI 53405 | 2016-05-02 |
| 1215305487 | Denetta Lauraelaine Flowers | Licensed Practical Nurse | 4311 Durand Ave., #104, Mt.pleasant, WI 53405 | 2015-09-04 |
| 1841675204 | Colleen Koderca | Registered Nurse | 3317-meachem Rd, Racine, WI 53405 | 2015-07-28 |
| 1790102986 | Georges Wakim | Specialist/Technologist | 3811 Spring St., Suite 102, Racine, WI 53405 | 2014-03-25 |
| 1982021176 | Matthew F Patzke | Specialist/Technologist | 3811 Spring Street Suite 102, Racine, WI 53405 | 2014-03-25 |
| 1073930269 | Jessica Geisler | Specialist/Technologist | 3811 Spring Street Suite #102, Racine, WI 53405 | 2014-03-25 |
| Find all providers in zip 53405 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104052554 | Anthony Donald Wendorf | Psychologist | 840 Lake Avenue, Suite 101, Racine, WI 53403-1550 | 2009-05-29 |
| 1760696074 | Joyce Shirley Degenhart | Psychologist | 11 Greenwood Ct, Racine, WI 53402-1248 | 2007-05-09 |
| 1477623643 | Psychological & Counseling Services Inc | Psychologist | 6929 Mariner Dr Unit D, Racine, WI 53406-3938 | 2006-11-08 |
| 1033295571 | Russell William Kinkade Jr. | Psychologist | 6214 Washington Avenue, Suite C 10, Racine, WI 53406 | 2006-10-27 |
| 1326310459 | Rondi J Rork Phd LLC | Psychologist | 6015 Durand Ave, Suite 450, Racine, WI 53406-5089 | 2012-02-06 |
| 1164723409 | Marie M Miller | Psychologist | 3701 Durand Ave, Suite 325, Racine, WI 53405-4458 | 2010-11-03 |
| 1558577395 | Martin James Poe | Psychologist | 5200 Washington Ave, Suite 203, Racine, WI 53406-4238 | 2007-05-16 |
| 1437377900 | Shamin Catherine Jaffer Ladhani | Psychologist | 1320 Wisconsin Ave, Racine, WI 53403-1978 | 2007-04-23 |
| 1134288392 | Tammy Lynn Zimmel | Psychologist | 3701 Durand Ave, Suite 325, Racine, WI 53405-4458 | 2006-12-06 |
| 1316021405 | D Martin Hayden | Psychologist | 840 Lake Ave, Racine, Racine, WI 53403-1566 | 2006-10-25 |
| Find all providers in RACINE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.