Kristy L Petersen, ARNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

ARNP9335906 Issued in FL

Practice address

540 The Rialto
Venice, FL 34285-2900

Phone

(941) 486-6927

Fax

(941) 486-6931

NPI assigned

Apr 6, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alive Hospice, Inc

  • Community Based Hospice Care Agency
  • Nashville, TN
  • NPI 1184682858
  NPD
• Alive Hospice, Inc.

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1114241437
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522972800000",
    "number": "1003313115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850001",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328850001",
            "telephone_number": "941-486-6927",
            "fax_number": "941-486-6931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 THE RIALTO",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342852900",
            "telephone_number": "941-486-6927",
            "fax_number": "941-486-6931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "KRISTY",
        "middle_name": "L",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-06",
        "last_updated": "2018-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP9335906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP LICENSE",
            "identifier": "ARNP9335906",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Faith Perez, APRN
• Michelle Perkins, MSW, LCSW
• Gabrielle Perrone, DPT
• Lou Anne Perry, LMT
• Peter R Dumas MD PA
• Teresa Ann Peterson, PMHNP-BC
• Vincent Pflug, D.O.
• Cecilia Phan
• Wendy Marie Phelps-Byam, FNP-C
• Josie Elizabeth Phifer

• Gerontology Nurse Practitioner in Venice, FL
• Providers in Venice, FL by specialty
• Gerontology Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.