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DR. STACY L PETERSON M.D.
NPI 1316030638
Surgery - Plastic and Reconstructive Surgery in Wichita, KS

Active since September 30, 2006
818 N EMPORIA ST, SUITE 305, WICHITA, KS 67214(316) 265-1441(316) 265-1685 Get Directions Write a Review

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

About Dr. Stacy L Peterson M.d. NPPES

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

DR. STACY L PETERSON M.D. (NPI 1316030638) is an individual plastic and reconstructive surgery provider in Wichita, Kansas, licensed in Kansas (0419242) and active in the NPI registry since September 2006.

NPPES Registry Identity

NPI1316030638
Entity TypeIndividualMale
Primary Taxonomy2086S0122X
Provider Legal NameDR. STACY L PETERSONCredential: M.D.
Location Address818 N EMPORIA ST, SUITE 305Wichita, KS 67214-3729
Mailing Address818 N Emporia St, Suite 305Wichita, KS 67214-3729 · (316) 265-1441 · Fax (316) 265-1685
Phone(316) 265-1441
Fax(316) 265-1685
Sole ProprietorYes
Enumeration DateSeptember 30, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1316030638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
License✔ Licensed in KS · 0419242
Definition
A surgeon who specializes in plastic and reconstructive surgery.
818 N EMPORIA ST, Wichita, KS 67214
Open in Google Maps ↗

Other Identifiers 2

Medicare ID-Type Unspecified010967KS
Medicare UPINB69280

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. DUANE L OSBORNE MD
Surgery
818 N EMPORIA ST, SUITE 200
WICHITA, KS 67214
Sedgwick County (316) 263-0296
DENNIS F MOORE JR. MD
Internal Medicine (Hematology & Oncology)
818 N EMPORIA ST, SUITE 403
WICHITA, KS 67214
Sedgwick County (316) 262-4467
BASSAM I MATTAR MD
Internal Medicine (Hematology & Oncology)
818 N EMPORIA ST, SUITE 403
WICHITA, KS 67214
Sedgwick County (316) 262-4467
MS. TRACY D SMITH APRN
Nurse Practitioner (Family)
818 N EMPORIA ST, SUITE 310
WICHITA, KS 67214
Sedgwick County (316) 263-5891
WICHITA NEPHROLOGY GROUP, PA
Internal Medicine (Nephrology)
818 N EMPORIA ST, SUITE 310
WICHITA, KS 67214
Sedgwick County (316) 263-5891
BERNARD T. POOLE, MD, PA
Orthopaedic Surgery
818 N EMPORIA ST, SUITE 107
WICHITA, KS 67214
Sedgwick County (316) 264-2806
DR. DAVID EUGENE WEBB M.D.
Internal Medicine (Nephrology)
818 N EMPORIA ST, SUITE 310
WICHITA, KS 67214
Sedgwick County (316) 263-5891
DR. JERRY BEBE COHLMIA M.D.
Internal Medicine (Nephrology)
818 N EMPORIA ST, SUITE 310
WICHITA, KS 67214
Sedgwick County (316) 263-5891

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 Stacy Peterson's NPI number?

The NPI number for Stacy Peterson is 1316030638. It was assigned to this individual provider in the NPPES registry on September 30, 2006.

Where is Stacy Peterson located?

Stacy Peterson practices at 818 N Emporia St Suite 305, Wichita, KS 67214. The listed phone number is (316) 265-1441.

What is Stacy Peterson's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

When was this NPI record last updated?

The NPPES record for Stacy 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.