WINSTON N PETERSEN PA-C
NPI 1194714717
Physician Assistant in Twin Falls, ID

Active since October 17, 2005
800 FALLS AVE, SUITE 2, TWIN FALLS, ID 83301(208) 734-6091(208) 734-4654 Get Directions Write a Review

NPPES record last updated: April 29, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Winston N Petersen Pa-c NPPES

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

WINSTON N PETERSEN PA-C (NPI 1194714717) is an individual physician assistant in Twin Falls, Idaho, licensed in Utah (262207-1206) and active in the NPI registry since October 2005.

NPPES Registry Identity

NPI1194714717
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameWINSTON N PETERSENCredential: PA-C
Location Address800 FALLS AVE, SUITE 2Twin Falls, ID 83301-3366
Mailing Address811 N 900 WOrem, UT 84057-7701 · (801) 434-7600 · Fax (801) 434-7604
Fax(208) 734-4654
Sole ProprietorNo
Enumeration DateOctober 17, 2005
Last NPPES UpdateApril 29, 2016
NPI 1194714717 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in UT · 262207-1206
Definition
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 scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
800 FALLS AVE, Twin Falls, ID 83301

Other Identifiers 13

Other000010165446ID · Regence Blue Shield Of Id
Medicare PIN1665097
Medicare PIN16650972
Medicare UPINQ40727UT
Medicare PIN16650971
OtherPAG40ID · Blue Cross Of Idaho
Medicaid807969001ID
Other000010165445ID · Regence Blue Shield Of Id
OtherPAG41ID · Blue Cross Of Idaho
Other000010165444ID · Regence Blue Shield
OtherPAG39ID · Blue Cross Of Idaho
Medicaid807969002ID
Medicaid807969000ID

Other Providers at the Same Location NPPES 3

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

Allergy & Immunology (Allergy)
800 FALLS AVE, SUITE 2
TWIN FALLS, ID 83301
Nurse Practitioner (Family)
800 FALLS AVE, SUITE 2
TWIN FALLS, ID 83301
Allergy & Immunology (Allergy)
800 FALLS AVE, SUITE 2
TWIN FALLS, ID 83301

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 Winston Petersen's NPI number?

The NPI number for Winston Petersen is 1194714717. It was assigned to this individual provider in the NPPES registry on October 17, 2005.

Where is Winston Petersen located?

Winston Petersen practices at 800 Falls Ave Suite 2, Twin Falls, ID 83301. The listed phone number is (208) 734-6091.

What is Winston Petersen's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Winston Petersen was last updated on April 29, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.