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JANE ANNETTE PETERSON PA-C
NPI 1184643827
Physician Assistant - Medical in Appleton, WI

Active since July 19, 2006PECOS Enrolled
10 TRI PARK WAY, APPLETON, WI 54914(920) 831-0070(920) 831-7939 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jane Annette Peterson Pa-c NPPES

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

JANE ANNETTE PETERSON PA-C (NPI 1184643827) is an individual medical provider in Appleton, Wisconsin, licensed in Wisconsin (194-023) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1184643827
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameJANE ANNETTE PETERSONCredential: PA-C
Location Address10 TRI PARK WAYAppleton, WI 54914-1658
Mailing AddressN288 Woodstock LnAppleton, WI 54915-3975 · (920) 687-0769
Phone(920) 831-0070
Fax(920) 831-7939
Sole ProprietorNo
Enumeration DateJuly 19, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1184643827 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in WI · 194-023
10 TRI PARK WAY, Appleton, WI 54914
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jane Annette Peterson Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

DR. MINDEE JUVE PHD
Psychologist (Clinical)
10 TRI PARK WAY
APPLETON, WI 54914
Outagamie County (920) 831-0070
MRS. KAY ELLEN MARSICEK BSN
Registered Nurse
10 TRI PARK WAY
APPLETON, WI 54914
Outagamie County (920) 831-0070
DR. BRIAN MICHAEL DEMURI MD
Psychiatry & Neurology (Psychiatry)
10 TRI PARK WAY
APPLETON, WI 54914
Outagamie County (920) 831-7908
KARLA OPHEIM
Pharmacist (Psychiatric)
10 TRI PARK WAY
APPLETON, WI 54914
Outagamie County (920) 831-0070
GAIL MARY MCNUTT MD
Internal Medicine
10 TRI PARK WAY
APPLETON, WI 54914
Outagamie County (920) 831-0070
SHIRLEY ANN WURZER RN
Registered Nurse (Ambulatory Care)
10 TRI PARK WAY
APPLETON, WI 54914
Outagamie County (920) 831-0070
AMY H STACK
Registered Nurse
10 TRI PARK WAY
APPLETON, WI 54914
Outagamie County (920) 831-0070
MARY JO STASTNY MD
Internal Medicine
10 TRI PARK WAY
APPLETON, WI 54914
Outagamie County (920) 831-7919

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 Jane Peterson's NPI number?

The NPI number for Jane Peterson is 1184643827. It was assigned to this individual provider in the NPPES registry on July 19, 2006.

Where is Jane Peterson located?

Jane Peterson practices at 10 Tri Park Way, Appleton, WI 54914. The listed phone number is (920) 831-0070.

What is Jane Peterson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Jane Peterson enrolled in Medicare?

Yes. Jane Peterson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jane Peterson was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.