Eliza S. Petersen, AUD, CCCA
NPI 1083750996ActiveIndividual· Audiologist· Driggs, ID
Audiologist (AUD, CCCA) in Driggs, Idaho, licensed in ID and WY, with an NPI issued in January 2007.
Overview
| NPI | 1083750996 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | AUD, CCCA |
| Sole proprietor | Yes |
| NPI issued | Jan 29, 2007 |
| Last updated in NPPES | Apr 19, 2023 |
| Certified by provider | Apr 19, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Audiologist Primary | 231H00000X | AUD-1142 | ID |
| Audiologist | 231H00000X | A-974 | WY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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