1. Home
  2. Directory
  3. Utah
  4. Ogden
  5. Physician Assistant
  6. NPI Profile

DEREK PETERSEN PA-C
NPI 1104365113
Physician Assistant in Ogden, UT

Active since February 23, 2017
2240 ADAMS AVE, OGDEN, UT 84401(801) 393-5355 Get Directions Write a Review

NPPES record last updated: February 3, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Feb 3, 2026, Feb 23, 2017 (2 updates tracked since 2017).

About Derek Petersen Pa-c NPPES

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

DEREK PETERSEN PA-C (NPI 1104365113) is an individual physician assistant provider in Ogden, Utah, licensed in Utah (10232646-1206) and active in the NPI registry since February 2017. He maintains a secondary practice location in Washington Terrace.Information from the official NPPES registry record, last updated February 3, 2026.

NPPES Registry Identity

NPI1104365113
Entity TypeIndividualMale
Provider Legal NameDEREK PETERSENCredential: PA-C
Location Address2240 ADAMS AVEOgden, UT 84401-1511
Mailing Address2240 Adams AveOgden, UT 84401-1511 · (801) 393-5355 · Fax (801) 394-4609
Phone(801) 393-5355
Sole ProprietorNo
Enumeration DateFebruary 23, 2017
Last NPPES UpdateFebruary 3, 20262 updates tracked since enumeration
NPPES CertifiedFebruary 3, 2026
✔ NPI 1104365113 is a valid, active identifier and passes the ISO check-digit test. How NPI validation works

★ Primary Specialty

Physician Assistant

Taxonomy 363A00000X · Physician Assistants & Advanced Practice Nursing Providers

✔ Licensed in UT · 10232646-1206

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the… Show more

2240 ADAMS AVE, Ogden, UT 84401
Open in Google Maps ↗

Also on File with NPPES

Secondary Location1
5285 S 400 E Ste A
Washington Terrace, UT 84405-7194
Phone (801) 334-0048 · Fax (833) 428-8406
Accepted insurance plans are listed on the Insurance tab. Issuers include BridgeSpan Health Company, Imperial Health Plan of the Southwest, Inc., Molina Healthcare and more.Insurance ›

Reviews for DEREK PETERSEN PA-C

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

MS. ANGELA EPSTEIN PA-C
Physician Assistant
2240 ADAMS AVE
OGDEN, UT 84401
Weber County (801) 393-5355
DR. MARK HOUSLEY MD
Family Medicine
2240 ADAMS AVE
OGDEN, UT 84401
Weber County (801) 393-5355
DR. RICHARD J GREGOIRE MD, PHD
Family Medicine
2240 ADAMS AVE
OGDEN, UT 84401
Weber County (801) 393-5355
DR. KURT E RIFLEMAN MD
Family Medicine
2240 ADAMS AVE
OGDEN, UT 84401
Weber County (801) 393-5355
JACK W CROSLAND MD
Orthopaedic Surgery
2240 ADAMS AVE
OGDEN, UT 84401
Weber County (801) 393-5355
MRS. TIFFANIE ANN HAUN NP
Nurse Practitioner (Family)
2240 ADAMS AVE
OGDEN, UT 84401
Weber County (801) 393-5355
MR. NATHAN MARK HADLEY LCSW
Social Worker (Clinical)
2240 ADAMS AVE
OGDEN, UT 84401
Weber County (801) 393-5355
KENNETH ALLEN GARCIA PA-C
Physician Assistant (Surgical)
2240 ADAMS AVE
OGDEN, UT 84401
Weber County (801) 393-5355
DR. STANLEY TANNER GRAHAM M.D.
Family Medicine
2240 ADAMS AVE
OGDEN, UT 84401
Weber County (801) 393-5355
MR. CRAIG STEPHEN BOWDEN PA-C
Physician Assistant
2240 ADAMS AVE
OGDEN, UT 84401
Weber County (801) 393-5355
SAGE RYLANT UKENA APRN
Nurse Practitioner (Family)
2240 ADAMS AVE
OGDEN, UT 84401
Weber County (801) 393-5355
DR. JESSICA GRIFFIN PHARM.D
Pharmacist
2240 ADAMS AVE
OGDEN, UT 84401
Weber County (801) 395-8200
KATHRYN EVANS
Physician Assistant
2240 ADAMS AVE
OGDEN, UT 84401
Weber County (801) 393-5355
AMANDA GOUGLER
Physician Assistant
2240 ADAMS AVE
OGDEN, UT 84401
Weber County (801) 393-5355
ANGELEENA HARRISON
Pharmacist
2240 ADAMS AVE
OGDEN, UT 84401
Weber County (801) 395-8200
MIDTOWN COMMUNITY HEALTH CENTER INC
Pharmacy (Clinic Pharmacy)
2240 ADAMS AVE
OGDEN, UT 84401
Weber County (801) 395-8200
DR. BROCK D ROSE DMD
Dentist
2240 ADAMS AVE
OGDEN, UT 84401
Weber County (801) 393-5355
DR. JUSTIN SHANE WHITE D.O.
Family Medicine
2240 ADAMS AVE
OGDEN, UT 84401
Weber County (801) 393-5355
MR. RYAN R HORNING PA-C
Physician Assistant
2240 ADAMS AVE
OGDEN, UT 84401
Weber County (801) 393-5355
MATTHEW JACKSON PA-C, MPAS
Family Medicine
2240 ADAMS AVE
OGDEN, UT 84401
Weber County (801) 393-5355

Frequently Asked Questions

What is Derek Petersen's NPI number?

The NPI number assigned to this healthcare provider is 1104365113, enumerated as an "individual" on February 23, 2017.

Where is the provider located?

The provider is located at 2240 ADAMS AVE OGDEN, UT 84401 and the phone number is (801) 393-5355.

What is the provider's specialty?

Physician Assistant with taxonomy code 363A00000X.

What insurance does Derek Petersen accept?

The provider might be accepting Accepts: BridgeSpan Health Company, Imperial Health Plan of. Please consult your insurance carrier or call the provider to verify.