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

Individual provider Medical Physician Assistant · NPI 1891123543

Mr. Henry Petersen, PA-C is a Physician Assistant in Coeur D Alene, Idaho. Qualified in 2013, 13 years ago. Practices with Kootenai Health Inc, a 394-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Idaho.

Years since qualifying
13
Licensed in
ID
In the registry since
2013
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

700 W Ironwood Dr Ste 320
Coeur D Alene, ID 83814-2656
Phone: (208) 625-5250
Fax: (208) 625-5251
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA-1146 (ID)

Record details

NPI number1891123543
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 16, 2013
Last updated in NPPESJuly 22, 2025
Certification dateJuly 22, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Kootenai Health Inc — 394 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Coeur D Alene