Jerry D Peterie, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

0416578 Issued in KS

Practice address

310 S Hillside St
Wichita, KS 67211-2129

Phone

(316) 264-3505

Fax

(316) 264-0908

NPI assigned

Jun 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jerry.peterie@khindirect.org
• Direct secure messaging: jerry.peterie.1@20807.direct.athenahealth.com

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.

• Mid-Kansas Women'S Center P.a.

  • Obstetrics & Gynecology Physician
  • Wichita, KS
  • NPI 1568456945
  NPD (past)

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1023014305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 S HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672112129",
            "telephone_number": "316-264-3505",
            "fax_number": "316-264-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672112129",
            "telephone_number": "316-264-3505",
            "fax_number": "316-264-0908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 N Waldron St Ste 5",
            "address_purpose": "LOCATION",
            "city": "Hutchinson",
            "state": "KS",
            "postal_code": "675021176",
            "country_code": "US",
            "telephone_number": "620-728-1498",
            "fax_number": "620-728-1838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERIE",
        "first_name": "JERRY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "KS",
            "license": "0416578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medicalrecords@idckansas.com",
            "affiliation": "N",
            "address_1": "2100 N Waldron St Ste 5",
            "city": "Hutchinson",
            "state": "KS",
            "country_code": "US",
            "postal_code": "675021176",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medicalrecords@idckansas.com",
            "affiliation": "N",
            "address_1": "310 S Hillside St",
            "city": "Wichita",
            "state": "KS",
            "country_code": "US",
            "postal_code": "672112129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Erin A. Peters, MPT
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• Infectious Disease Physician in Wichita, KS
• Providers in Wichita, KS by specialty
• Infectious Disease Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.