Kenneth B Peterson (NPI# 1083706659, PAC ID# 6709067911) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1083706659 |
| PAC ID by PECOS | 6709067911 |
| Professional Enrollment ID | I20110222000281 |
| Full Name | Kenneth B Peterson |
| Organization Legal Name | BLACK HILLS SURGICAL HOSPITAL, LLP |
| Address |
1730 Haines Ave Rapid City SD 57701-0615 |
| Phone Number | 6057917788 |
| Gender | M |
| Medical School | UNIVERSITY OF SOUTH DAKOTA SCHOOL OF MEDICINE |
| Graduation Year | 1980 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 5496742835 |
| Number of Group Practice Members | 60 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 430091 | BLACK HILLS SURGICAL HOSPITAL LLP |
| Address | Phone | Organization |
|---|---|---|
| 1730 Haines Ave, Rapid City, SD 57701-0615 | 6057917788 | BLACK HILLS SURGICAL HOSPITAL, LLP |
| Organization Legal Name | BLACK HILLS SURGICAL HOSPITAL, LLP |
| Physicians | 69 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lowell R Amiotte | Anesthesiology | Black Hills Surgical Hospital, LLP | 216 Anamaria Dr, Rapid City, SD 57701-7366 |
| Danielle L Shafer | Physician Assistant | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| Daryl S Dickson | Family Medicine | Black Hills Surgical Hospital, LLP | 741 Mountain View Rd, Suite 1, Rapid City, SD 57702-2539 |
| Angela R Anderson | Pediatric Medicine | Black Hills Surgical Hospital, LLP | 120 E Michigan St, Spearfish, SD 57783-1506 |
| Joseph W Amo | Certified Registered Nurse Anesthetist (crna) | Black Hills Surgical Hospital, LLP | 216 Anamaria Dr, Rapid City, SD 57701-7366 |
| Christine M Zambon | Physician Assistant | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| Peter J Schwiesow | Certified Registered Nurse Anesthetist (crna) | Black Hills Surgical Hospital, LLP | 216 Anamaria Dr, Rapid City, SD 57701-7366 |
| Kelly A Morgan | Anesthesiology | Black Hills Surgical Hospital, LLP | 216 Anamaria Dr, Rapid City, SD 57701-7366 |
| David W Marshall | Certified Registered Nurse Anesthetist (crna) | Black Hills Surgical Hospital, LLP | 216 Anamaria Dr, Rapid City, SD 57701-7366 |
| Maryann Marrs | Nurse Practitioner | Black Hills Surgical Hospital, LLP | 216 Anamaria Dr, Rapid City, SD 57701-7366 |
| Street Address |
1730 HAINES AVE |
| City | RAPID CITY |
| State | SD |
| Zip | 57701-0615 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Danielle L Shafer | Physician Assistant | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| Christine M Zambon | Physician Assistant | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| Cheryl L Reagan | Nurse Practitioner | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| David K Custis | Physician Assistant | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| Laurie A Giacoletto | Physician Assistant | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| Blake T Greenfield | Physician Assistant | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| Joshua R Paull | Physician Assistant | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| Ashley M Anziano | Physician Assistant | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| Helen A Kuehlman | Family Medicine | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| Eric D Ottenbacher | Physician Assistant | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Roberta A Kramlich | Psychologist, Clinical | R. P. Renka, M.d.,p.c. | 528 Qunicy St, Rapid City, SD 57701 |
| Ericka L Privitt | Nurse Practitioner | Black Hills Dermatology PC | 7236 Jordan Dr, Suite 101, Rapid City, SD 57701 |
| Julie A Krein | Nurse Practitioner | Black Hills Dermatology PC | 7236 Jordan Dr, Suite 101, Rapid City, SD 57701 |
| Vassilia D Young | Dermatology | Black Hills Dermatology PC | 7236 Jordan Dr, Suite 101, Rapid City, SD 57701 |
| Richard P Renka | Psychiatry | R. P. Renka, M.d.,p.c. | 528 Qunicy St, Rapid City, SD 57701 |
| Michael R Birgenheir | Physician Assistant | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| Audrey R Mcreavy | Physician Assistant | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| Jerry Mcreavy | Physician Assistant | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| Lynette R Siewert | Physician Assistant | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| Daniel Edwin Holloway | Optometry | Holloway Vision Care, LLC | 2200 N Maple Ave, Rapid City, SD 57701-1058 |
| Find all physicians in zip 57701 | |||
| City | RAPID CITY |
| Zip Code | 57701 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | RAPID CITY + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Kenneth B Peterson.
| 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.