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JOHN J PETERSEN PA
NPI 1164580429
Physician Assistant - Surgical in Medford, OR

Active since December 05, 2006
520 MEDICAL CENTER DR, SUITE 201, MEDFORD, OR 97504(541) 789-5710 Get Directions Write a Review

NPPES record last updated: January 16, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About John J Petersen Pa NPPES

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

JOHN J PETERSEN PA (NPI 1164580429) is an individual surgical provider in Medford, Oregon, licensed in Oregon (PA00228) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1164580429
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameJOHN J PETERSENCredential: PA
Location Address520 MEDICAL CENTER DR, SUITE 201Medford, OR 97504-4334
Mailing Address2620 E Barnett Rd, Suite HMedford, OR 97504-8344 · (541) 789-5250
Phone(541) 789-5710
Sole ProprietorNo
Enumeration DateDecember 5, 2006
Last NPPES UpdateJanuary 16, 2013
✔ NPI 1164580429 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in OR · PA00228
520 MEDICAL CENTER DR, Medford, OR 97504
Open in Google Maps ↗

Other Identifiers 2

Medicare PINR164473OR
Medicaid500613512OR

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DONALD L BOWSER NP
Internal Medicine (Cardiovascular Disease)
520 MEDICAL CENTER DR, SUITE 100
MEDFORD, OR 97504
Jackson County (541) 789-5704
SOUTHERN OREGON CARDIOLOGY LLC
Internal Medicine (Cardiovascular Disease)
520 MEDICAL CENTER DR, STE 200
MEDFORD, OR 97504
Jackson County (541) 282-6600
DANIEL NEVILLE
Physician Assistant (Surgical)
520 MEDICAL CENTER DR, SUITE 201
MEDFORD, OR 97504
Jackson County (541) 789-5710
APP CARDIOVASCULAR SURGEONS
Thoracic Surgery (Cardiothoracic Vascular Surgery)
520 MEDICAL CENTER DR, SUITE 201
MEDFORD, OR 97504
Jackson County (541) 789-5710
ERIC A PENA MD FACC
Internal Medicine (Clinical Cardiac Electrophysiology)
520 MEDICAL CENTER DR, SUITE 200
MEDFORD, OR 97504
Jackson County (541) 282-6606
DR. JAEKYOUNG AUDREY HONG MD
Internal Medicine (Interventional Cardiology)
520 MEDICAL CENTER DR, SUITE 200
MEDFORD, OR 97504
Jackson County (541) 930-7222
DANI J THOMAS DO
Internal Medicine (Critical Care Medicine)
520 MEDICAL CENTER DR, SUITE 2001
MEDFORD, OR 97504
Jackson County (541) 789-5710
CARDIOVASCULAR INSTITUTE OF SOUTHERN OREGON, LLC
Clinic/Center (Medical Specialty)
520 MEDICAL CENTER DR, SUITE 150
MEDFORD, OR 97504
Jackson County (541) 282-6660

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 John Petersen's NPI number?

The NPI number for John Petersen is 1164580429. It was assigned to this individual provider in the NPPES registry on December 5, 2006.

Where is John Petersen located?

John Petersen practices at 520 Medical Center Dr Suite 201, Medford, OR 97504. The listed phone number is (541) 789-5710.

What is John Petersen's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for John Petersen was last updated on January 16, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.