National Provider Identifier Database

MARY T CARR PETERSON, PA – NPI #1164496212
Physician Assistant

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.


Contact Information

MARY T CARR PETERSON, PA
1410 SW TRADITION DR STE 110
ANKENY, IA50023
Phone: 515-875-9696
Fax: 515-875-9697
Website:
Specialty Taxonomy Code
* Physician Assistant 363A00000X
Medical 363AM0700X

* Indicates primary specialty

NPI Profile & details for MARY T CARR PETERSON

NPI Number 1164496212
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 02/15/2006
Last updated 08/07/2025 - About 10 months ago
Sole proprietor1 No
Identifiers
  • IA License #: 001597
  • IA Medicaid: 0634600
  • IA Medicaid: 1117994
  • IA Medicaid: 2117994
  • IA Medicaid: 3117994
  • Other: 37902 WELLMARK
  • Other: 37903 WELLMARK
  • Other: 37904 WELLMARK
  • Other: 37905 WELLMARK
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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