Kenneth W Petersen (NPI# 1568637395, PAC ID# 5193899573) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1568637395 |
| PAC ID by PECOS | 5193899573 |
| Professional Enrollment ID | I20130611000877 |
| Full Name | Kenneth W Petersen |
| Organization Legal Name | CASS REGIONAL MEDICAL CENTER |
| Address |
300 S Main St Peculiar Medical Clinic Peculiar MO 64078-9603 |
| Phone Number | 8167791100 |
| Gender | M |
| Medical School | UNIVERSITY OF HEALTH SCIENCES/CHICAGO MEDICAL SCHOOL |
| Graduation Year | 2003 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Group Practice PAC ID | 7517853781 |
| Number of Group Practice Members | 37 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 261324 | CASS REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2800 E Rock Haven Rd, Harrisonville, MO 64701-4411 | 8163803474 | CASS REGIONAL MEDICAL CENTER |
| 300 S Main St, Peculiar Medical Clinic, Peculiar, MO 64078-9603 | 8167791100 | CASS REGIONAL MEDICAL CENTER |
| Organization Legal Name | CASS REGIONAL MEDICAL CENTER |
| Physicians | 29 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jolie R Chance | Family Medicine | Cass Regional Medical Center | 1601 N State Route 7, Pleasant Hill Medical Clinic, Pleasant Hill, MO 64080-1945 |
| Jackie D Kumm | Nurse Practitioner | Cass Regional Medical Center | 300 S Main St, Peculiar Medical Clinic, Peculiar, MO 64078-9603 |
| William G Cruce | Podiatry | Cass Regional Medical Center | 2316 E Meyer Blvd 3, Select Specialty Hospital Western Missouri, Kansas City, MO 64132-1136 |
| Stephanie Duarte | Nurse Practitioner | Cass Regional Medical Center | 2800 E Rock Haven Rd, Harrisonville, MO 64701-4411 |
| Kristin K Anstine | Nurse Practitioner | Cass Regional Medical Center | 305 E Pacific St, Kingsville Medical Clinic, Kingsville, MO 64061-2512 |
| Richard C Price | Family Medicine | Cass Regional Medical Center | 2800 E Rock Haven Rd, Harrisonville, MO 64701-4411 |
| Alberto Suarez Jr. | Family Medicine | Cass Regional Medical Center | 2800 E Rock Haven Rd, Harrisonville, MO 64701-4411 |
| Kristi L Schnorf Mccully | Certified Registered Nurse Anesthetist (crna) | Cass Regional Medical Center | 2800 E Rock Haven Rd, Harrisonville, MO 64701-4411 |
| Molly R Urton | Nurse Practitioner | Cass Regional Medical Center | 300 S Main St, Peculiar Medical Clinic, Peculiar, MO 64078-9603 |
| Jack R Hudkins | General Surgery | Cass Regional Medical Center | 2800 E Rock Haven Rd, Harrisonville, MO 64701-4411 |
| Street Address |
300 S MAIN ST PECULIAR MEDICAL CLINIC |
| City | PECULIAR |
| State | MO |
| Zip | 64078-9603 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jackie D Kumm | Nurse Practitioner | Cass Regional Medical Center | 300 S Main St, Peculiar Medical Clinic, Peculiar, MO 64078-9603 |
| Michael A Hicks | Nurse Practitioner | Express Family Care | 300 S Main St, Crescent City, FL 32112-2729 |
| Molly R Urton | Nurse Practitioner | Cass Regional Medical Center | 300 S Main St, Peculiar Medical Clinic, Peculiar, MO 64078-9603 |
| Monica Master | Nurse Practitioner | Amg - Southern Tennessee, LLC | 300 S Main St, Estill Springs, TN 37330-4042 |
| John Glen Carson | Nurse Practitioner | Amg - Southern Tennessee, LLC | 300 S Main St, Estill Springs, TN 37330-4042 |
| John C Milanick | Family Medicine | Medex Medical Express of Palatka LLC | 300 S Main St, Crescent City, FL 32112-2729 |
| William T Swearingen | Family Medicine | Norman Regional Providers-primary Care | 300 S Main St, Primary Care Newcastle, Newcastle, OK 73065-5403 |
| Edwin C Winder Iii | Optometry | 300 S Main St, Tooele, UT 84074-2746 | |
| Rebeca Juarbe Arrillaga | Internal Medicine | Express Family Care | 300 S Main St, Crescent City, FL 32112-2729 |
| Walter J Boyanton Iii | Family Medicine | Amg - Southern Tennessee, LLC | 300 S Main St, Estill Springs, TN 37330-4042 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Laura Prater Geoghegan | Nurse Practitioner | Cass Regional Medical Center | 300 S Main St, Peculiar Medical Clinic, Peculiar, MO 64078-9603 |
| Thayer P Banwart | Chiropractic | 201 S State Route C, Peculiar, MO 64078-9729 |
| City | PECULIAR |
| Zip Code | 64078 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | PECULIAR + ORTHOPEDIC SURGERY |
Please comment or provide details below to improve the information on Kenneth W Petersen.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.