Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Derek Petersen, PA-C

Individual provider Physician Assistant · NPI 1104365113

Derek Petersen, PA-C is a Physician Assistant in Ogden, Utah. Works from 2 locations. Licensed in Utah.

Licensed in
UT
In the registry since
2017
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2240 Adams Ave
Ogden, UT 84401-1511
Phone: (801) 393-5355
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5285 S 400 E Ste A, Washington Terrace, UT 84405-7194 — (801) 334-0048

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10232646-1206 (UT)

Record details

NPI number1104365113
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 23, 2017
Last updated in NPPESFebruary 3, 2026
Certification dateFebruary 3, 2026
Mailing address2240 Adams Ave, Ogden, UT 84401-1511

Other providers in Ogden