KELLEY ANN PETERSON (P.A.-C.) – Physician Assistant, NPI 1477555886

KELLEY ANN PETERSON (P.A.-C.) is a healthcare provider. based in Clive, Iowa. specializing in Physician Assistant. They hold the professional credentials P.A.-C.. They hold a License No. 01571 (IA). The NPI Number for KELLEY ANN PETERSON (P.A.-C.) is 1477555886

Main info

Female
Name
KELLEY ANN PETERSON (P.A.-C.)
NPI
1477555886
Phone
(515) 277-8900
Address
13682 LAKE SHORE DR
Enumeration Date
15 August 2005
Last Update Date
8 July 2007
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for KELLEY ANN PETERSON (P.A.-C.)

  • 13682, Lake Shore Drive, Clive, Polk County, Iowa, 50323, United States

    CLIVE, IA 503258640

    Phone: (515) 277-8900

    Fax: (515) 223-7361

    Type: Mailing

  • Dermatology PC, 6000, University Avenue, West Lakes Office Park, West Des Moines, Dallas County, Iowa, 50398, United States

    SUITE 310

    WEST DES MOINES, IA 502668203

    Phone: (515) 277-8900

    Fax: (515) 223-7361

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 50325)

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Reviews

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Frequently asked questions

How do payers reference KELLEY ANN PETERSON (P.A.-C.)?
For KELLEY ANN PETERSON (P.A.-C.), use NPI 1477555886 as the unique 10-digit identifier.
Active or inactive — what applies to KELLEY ANN PETERSON (P.A.-C.)?
You should see KELLEY ANN PETERSON (P.A.-C.) as active in CMS-hosted NPPES data.
What clinical focus is listed for KELLEY ANN PETERSON (P.A.-C.)?
At a glance, KELLEY ANN PETERSON (P.A.-C.) is tied to Physician Assistant. Clinical services aligned with this taxonomy classification.
Is KELLEY ANN PETERSON (P.A.-C.) located near Clive?
KELLEY ANN PETERSON (P.A.-C.) currently maps to Clive, Iowa in this extract.
Can I trust this NPI listing for KELLEY ANN PETERSON (P.A.-C.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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