Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kathryn Peterson, PA-C

Individual provider Physician Assistant · NPI 1093302630

Kathryn Peterson, PA-C is a Physician Assistant in Vermillion, South Dakota. Qualified in 2020, 6 years ago. Practices with Sanford Health Network, a 364-clinician group and accepts Medicare assignment. Licensed in Minnesota and South Dakota.

Years since qualifying
6
Licensed in
MN, SD
In the registry since
2020
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

20 S Plum St
Vermillion, SD 57069-3346
Phone: (605) 677-3700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 13545 (MN)
Physician Assistant Taxonomy 363A00000X · Licence 1652 (SD)

Record details

NPI number1093302630
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 29, 2020
Last updated in NPPESOctober 27, 2025
Certification dateOctober 27, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Sanford Health Network — 364 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Vermillion