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DR. KENNETH WENDELL PETERSEN D.O. NPI 1568637395


NPI Information

NPI: 1568637395
Provider Name: DR. KENNETH WENDELL PETERSEN, D.O.
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
2820 E ROCK HAVEN RD
SUITE # 120
HARRISONVILLE, MO
ZIP 64701
Phone: (816) 380-7662
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DR. Kenneth Wendell Petersen, D.O. is an orthopaedic surgery in Harrisonville, MO with 25 years of experience. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. DR. Kenneth Wendell Petersen, D.O. NPI is 1568637395. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: R FRANKLIN UNIVERSITY OF MED & SCI/CHICAGO MEDICAL SCHOOL
Graduation Year:1999

The provider's business location address is:

2820 E ROCK HAVEN RD
SUITE # 120
HARRISONVILLE, MO
ZIP 64701-411
Phone: (816) 380-7662

The NPI 1568637395 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/23/2008 and was last updated on 10/8/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207X00000XOrthopaedic Surgery05-33327KANSASNo
2207X00000XOrthopaedic Surgery2013002819MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1033C466DMEDICARE PINKANSAS
2200570110AMEDICAIDKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.