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DR. ELIZA S. PETERSEN AUD, CCCA
NPI 1083750996
Audiologist in Driggs, ID

Active since January 29, 2007
2740 SHADOWMOON LN STE 417, DRIGGS, ID 83422(307) 745-5587(877) 515-1633 Get Directions Write a Review

NPPES record last updated: April 19, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 1, 2020, Nov 17, 2020 (2 updates tracked since 2020).

About Dr. Eliza S. Petersen Aud, Ccca NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ELIZA S. PETERSEN AUD, CCCA (NPI 1083750996) is an individual audiologist in Driggs, Idaho, licensed in Idaho (AUD-1142) and active in the NPI registry since January 2007.

NPPES Registry Identity

NPI1083750996
Entity TypeIndividualFemale
Primary Taxonomy231H00000X
Provider Legal NameDR. ELIZA S. PETERSENCredential: AUD, CCCA
Location Address2740 SHADOWMOON LN STE 417Driggs, ID 83422-5083
Mailing Address1388 Mount Moriah RdLivermore, CO 80536-9311 · (307) 745-5587 · Fax (877) 515-1633
Phone(307) 745-5587
Fax(877) 515-1633
Sole ProprietorYes
Enumeration DateJanuary 29, 2007
Last NPPES UpdateApril 19, 20232 updates tracked since enumeration
NPPES CertifiedApril 19, 2023
✔ NPI 1083750996 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAudiologistSpeech, Language and Hearing Service Providers
Taxonomy Code231H00000X
Licenses✔ Licensed in ID · AUD-1142✔ Licensed in WY · A-974
Definition
(1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master's degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy.
2740 SHADOWMOON LN STE 417, Driggs, ID 83422
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Other Names 1

Former Name (1)Eliza Schwab Ma, Ccca, Faaa

Other Identifiers 2

Medicaid807694600ID
Medicaid125563100WY

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eliza Petersen's NPI number?

The NPI number for Eliza Petersen is 1083750996. It was assigned to this individual provider in the NPPES registry on January 29, 2007. The provider is also known as Eliza Schwab Ma, Ccca, Faaa.

Where is Eliza Petersen located?

Eliza Petersen practices at 2740 Shadowmoon Ln Ste 417, Driggs, ID 83422. The listed phone number is (307) 745-5587.

What is Eliza Petersen's specialty?

The primary specialty registered for this NPI is Audiologist with taxonomy code 231H00000X.

When was this NPI record last updated?

The NPPES record for Eliza Petersen was last updated on April 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.