MR. JEFFREY W. PETERSEN (NPI# 1952543969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952543969 |
| Entity Type | Individual |
| Full Name | MR. JEFFREY W. PETERSEN |
| Credential | ATC |
| Practice Address |
308 S 3rd St Watseka IL 60970-1604 |
| Practice Telephone | 8154321005 |
| Mailing Telephone | 8154321005 |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2009-04-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
096001426 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649312752 | Jeffrey Petersen | Internal Medicine | 300 Pasteur Dr # A175mc5309, Stanford, CA 94305-2200 | 2007-02-13 |
| 1669454211 | Jeffrey Ian Petersen | Dentist | 2448 Guerneville Rd, Santa Rosa, CA 95403-4175 | 2005-11-18 |
| 1912367251 | Jeffrey Petersen | Physical Therapist | 6640 Kaniksu St, Bonners Ferry, ID 83805-7532 | 2016-02-29 |
| 1912330085 | Jeffrey Daniel Petersen | Counselor | 2655 Enterprise Rd, Reno, NV 89512-1666 | 2013-08-13 |
| 1184998585 | Jeffrey Ming Petersen | Pathology | 10833 Le Conte Ave, 13-145a Center for Hlth Sci, Los Angeles, CA 90095-3075 | 2012-03-02 |
| 1891977419 | Jeffrey Scott Petersen | Counselor | 500 Crown Point Cir, Grass Valley, CA 95945-9514 | 2007-12-05 |
| 1841389699 | Jeffrey Petersen | Physical Therapist | 1844 E Baseline Rd Ste C5, Tempe, AZ 85283-1506 | 2006-10-12 |
| 1699794735 | Jeffrey Petersen | Family Medicine | 1035 S Main Ave, Fallbrook, CA 92028-3338 | 2006-07-19 |
| 1275551707 | Jeffrey E Petersen | Dermatology | 1011 Bowles Ave, Suite 121, Fenton, MO 63026-2395 | 2006-07-17 |
| Street Address |
308 S 3RD ST |
| City | WATSEKA |
| State | IL |
| Zip Code | 60970-1604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376189167 | Malinda S Mustered | Occupational Therapist | 825 S Belmont Ave, Watseka, IL 60970 | 2019-11-27 |
| 1558889188 | K-shayla Lafayette | Nurse Practitioner | 200 E. Fairman Ave., Watseka, IL 60970 | 2017-09-04 |
| 1144354879 | Pamela H. Beall | Counselor | 1801 N. State Route 1, Suite 2, Watseka, IL 60970 | 2007-03-15 |
| 1528111879 | Spine Clinics of America Sc | Chiropractor | 425 E. Walnut Street, Watseka, IL 60970 | 2007-01-19 |
| 1699833970 | Shakeel Sher Khan Sandozi | Surgery | 625 S Fifth Street, Watseka, IL 60970 | 2006-12-05 |
| 1790859866 | David Charles Nagele | Dentist | 130 N Littelfuse Ln, Suite 101, Watseka, IL 60970 | 2006-11-20 |
| 1942389259 | John M Rose | Dentist | 316 E Lincoln Ave, Watseka, IL 60970 | 2006-11-06 |
| 1952324279 | Bonita Jean Rajala | Counselor | 617 East Grant St., Watseka, IL 60970 | 2006-07-26 |
| 1396978177 | Allison Shindelar | Social Worker | 323 Wmulberry St, Watseka, IL 60970-0332 | 2009-08-27 |
| 1356441539 | Petersen Health Operations, LLC | Skilled Nursing Facility | 900 N Market St, Watseka, IL 60970-1048 | 2006-09-25 |
| Find all providers in zip 60970 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437242526 | Dara De Boer | Specialist/Technologist | 110 S 3rd St, Watseka, IL 60970-1666 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1104438621 | Abril Malagon | Specialist/Technologist | 1 S Greenwood Ave, Palatine, IL 60074-6328 | 2020-08-17 |
| 1265050678 | Megan Elsbree | Specialist/Technologist | 11819 Deacon Dr, Rockton, IL 61072-9411 | 2020-07-13 |
| 1013534437 | Nicole Rose Mondelli | Specialist/Technologist | 958 Tallgrass Dr, Bartlett, IL 60103-5071 | 2020-07-01 |
| 1740806413 | Megan Herter | Specialist/Technologist | 1513 Old Ivy Dr, Springfield, IL 62711-8156 | 2020-06-18 |
| 1164047239 | Madison Stagman | Specialist/Technologist | 280 Douglas Ave Apt 4, Mascoutah, IL 62258-2963 | 2020-06-14 |
| 1588286272 | Sarah Wegrzyn | Specialist/Technologist | 3040 S Wabash Ave, Chicago, IL 60616-3474 | 2020-05-15 |
| 1336761386 | Christine Louise Shebelski | Specialist/Technologist | 15203 Pulaski Rd, Midlothian, IL 60445-3755 | 2020-05-13 |
| 1386266633 | Kathryn Riordan | Specialist/Technologist | 221 Triton Ln, Naperville, IL 60540-7926 | 2020-05-09 |
| 1487276747 | Vianey Hernandez-ramirez | Specialist/Technologist | 4115 Howard St, Skokie, IL 60076-3749 | 2020-05-09 |
| Find all providers with the same taxonomy | ||||
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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.