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SUSAN K. PETERSON PA
NPI 1205946613
Physician Assistant - Medical in Fort Wayne, IN

Active since August 30, 2006
11143 PARKVIEW PLAZA DR, 100, FORT WAYNE, IN 46845(260) 484-8830(260) 483-1911 Get Directions Write a Review

NPPES record last updated: October 29, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Susan K. Peterson Pa NPPES

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

SUSAN K. PETERSON PA (NPI 1205946613) is an individual medical provider in Fort Wayne, Indiana, licensed in Indiana (10000342A) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1205946613
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameSUSAN K. PETERSONCredential: PA
Location Address11143 PARKVIEW PLAZA DR, 100Fort Wayne, IN 46845-1727
Mailing Address11143 Parkview Plaza Dr, 100Fort Wayne, IN 46845-1727 · (260) 484-8830 · Fax (260) 483-1911
Phone(260) 484-8830
Fax(260) 483-1911
Sole ProprietorNo
Enumeration DateAugust 30, 2006
Last NPPES UpdateOctober 29, 2009
✔ NPI 1205946613 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 IN · 10000342A
11143 PARKVIEW PLAZA DR, Fort Wayne, IN 46845
Open in Google Maps ↗

Other Identifiers 2

Other000000528371IN · Anthem Pin
Medicare PIN055770MIN

Other Providers at the Same Location NPPES 7

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

AAKASH PATEL PHARMD
Pharmacist (Pharmacotherapy)
11143 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845
Allen County (260) 266-4400
MS. KELSEY JOHNSON
Genetic Counselor, MS
11143 PARKVIEW PLAZA DR, SUITE 311
FORT WAYNE, IN 46845
Allen County (260) 482-3886
MRS. ANGELA MICHELLE BAUER N.P.
Nurse Practitioner (Family)
11143 PARKVIEW PLAZA DR, SUITE 311
FORT WAYNE, IN 46845
Allen County (260) 482-3886
MR. DANIEL R KONOW PA
Physician Assistant
11143 PARKVIEW PLAZA DR, SUITE 100
FORT WAYNE, IN 46845
Allen County (260) 484-8830
MINDY HARRIS FNP
Nurse Practitioner (Family)
11143 PARKVIEW PLAZA DR
FORT WAYNE, IN 46845
Allen County (260) 425-6330
NORTHEAST INDIANA GENETIC COUNSELING CENTER INC
Medical Genetics (Clinical Genetics (M.D.))
11143 PARKVIEW PLAZA DR, STE. 311
FORT WAYNE, IN 46845
Allen County (260) 482-3886
MEGHAN LUNDY MS, LCGC
Genetic Counselor, MS
11143 PARKVIEW PLAZA DR, STE. 311
FORT WAYNE, IN 46845
Allen County (260) 482-3886

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 Susan Peterson's NPI number?

The NPI number for Susan Peterson is 1205946613. It was assigned to this individual provider in the NPPES registry on August 30, 2006.

Where is Susan Peterson located?

Susan Peterson practices at 11143 Parkview Plaza Dr 100, Fort Wayne, IN 46845. The listed phone number is (260) 484-8830.

What is Susan Peterson's specialty?

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

When was this NPI record last updated?

The NPPES record for Susan Peterson was last updated on October 29, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.