DR. JACK T PETERSON JR. MD
NPI 1508860487
Specialist in Topeka, KS

Q: What is Jack Peterson's NPI number?

The NPI number for Jack Peterson is 1508860487. It was assigned to this individual provider in the NPPES registry on June 9, 2005.

Q: What is Jack Peterson's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Peterson was last updated on April 24, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since June 09, 2005PECOS Enrolled

631 SW HORNE ST, STE 400, TOPEKA, KS 66606(785) 234-9000(785) 234-9119 Get Directions Write a Review

NPPES record last updated: April 24, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Jack T Peterson Jr. Md NPPES

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

DR. JACK T PETERSON JR. MD (NPI 1508860487) is an individual specialist in Topeka, Kansas, licensed in Kansas (0422259) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS and is a graduate of Baylor College Of Medicine (1983).

NPPES Registry Identity

NPI1508860487

Entity TypeIndividualMale

Primary Taxonomy174400000X

Provider Legal NameDR. JACK T PETERSON JR.Credential: MD

Location Address631 SW HORNE ST, STE 400Topeka, KS 66606-1661

Mailing Address631 Sw Horne St, Ste 400Topeka, KS 66606-1661 · (785) 234-9000 · Fax (785) 234-9119

Phone(785) 234-9000

Fax(785) 234-9119

Sole ProprietorYes

Medical School CMSBaylor College Of MedicineGraduated 1983

Enumeration DateJune 9, 2005

Last NPPES UpdateApril 24, 2012

✔ NPI 1508860487 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in KS · 0422259

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

631 SW HORNE ST, Topeka, KS 66606

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Other Identifiers 7

Other240007246KS · Railroad Medicare

Medicare ID-Type Unspecified100516KS · Medicare For Dr. Peterson

Other481191346KS · Tax Id

Medicaid100144860BKS

Medicare UPIND09155KS

Other628770KS · First Guard

Other100516KS · Blue Cross

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Kansas, Inc..Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jack T Peterson Jr. Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5890838759

PECOS Enrollment IDI20100202000029

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 15

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

IM/ID MEDICAL CONSULTANTS

Internal Medicine (Endocrinology, Diabetes & Metabolism)

631 SW HORNE ST, SUITE 420
TOPEKA, KS 66606

Shawnee County (785) 234-8405

PARTNERS IN PEDIATRICS PA

Pediatrics (Adolescent Medicine)

631 SW HORNE ST, SUITE 340
TOPEKA, KS 66606

Shawnee County (785) 234-4624

RUPP UROLOGY LLC

Urology

631 SW HORNE ST, SUITE 150
TOPEKA, KS 66606

Shawnee County (785) 354-7877

SARAH ORBITA DAVIS

Nurse Practitioner (Family)

631 SW HORNE ST
TOPEKA, KS 66606

Shawnee County (785) 295-7962

TOPEKA NEUROLOGY ASSOCIATES, P.A.

Psychiatry & Neurology (Neurology)

631 SW HORNE ST, SUITE 200
TOPEKA, KS 66606

Shawnee County (785) 234-6300

CENTER FOR PLASTIC SURGERY, PA

Surgery (Plastic and Reconstructive Surgery)

631 SW HORNE ST, SUITE 400
TOPEKA, KS 66606

Shawnee County (785) 234-9000

WADE B WELCH M.D.

Psychiatry & Neurology (Neurology)

631 SW HORNE ST, STE 420
TOPEKA, KS 66606

Shawnee County (785) 295-7878

KATIE WOHLGEMUTH APRN

Nurse Practitioner

631 SW HORNE ST
TOPEKA, KS 66606

Shawnee County (785) 270-5000

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 Jack Peterson's NPI number?

The NPI number for Jack Peterson is 1508860487. It was assigned to this individual provider in the NPPES registry on June 9, 2005.

Where is Jack Peterson located?

Jack Peterson practices at 631 SW Horne St Ste 400, Topeka, KS 66606. The listed phone number is (785) 234-9000.

What is Jack Peterson's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Jack Peterson enrolled in Medicare?

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

What insurance does Jack Peterson accept?

Health plans from Blue Cross and Blue Shield of Kansas, Inc. list Jack Peterson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jack Peterson was last updated on April 24, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.