Allison L Petersen, PA-C
Physician Assistant in Madison, WI. Individual provider (NPI-1).
NPI number1982253654
StatusActive
Last updated in NPPESMay 13, 2024
Details
- NPI
- 1982253654
- Entity type
- Individual (NPI-1)
- Name
- Ms. Allison L Petersen
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 5, 2019
- Certification date
- May 13, 2024
- Last updated
- May 13, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 7670-23 | WI | Yes |
| 363A00000X | Physician Assistant | PA12971 | TX |
Other names
- Allison Childs (Former Name)
Practice location
2402 Winnebago StMadison, WI 53704-5341
Phone 608-828-7603
Mailing address
7974 Uw Health CtMiddleton, WI 53562-5531
Other practice locations
12221 Renfert Way Ste 110
Austin, TX 78758-5658
Austin, TX 78758-5658
Phone 512-601-0303 · Fax 512-601-0333
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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