Jenifer R. Peters, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA930 Issued in SC

Practice address

1202 E Butler Rd
Greenville, SC 29607-5910

Phone

(864) 627-3800

Fax

(864) 672-2654

NPI assigned

Jun 28, 2006

Last updated

Feb 11, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allergic Disease and Asthma Center PAGroup PAC ID 7113992660, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DJDDCA/Endpoint/DJDDCA

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

• Allergic Disease and Asthma Center PA

  • Allergy Physician
  • Greenville, SC
  • NPI 1952302853
  Medicare reassignment Care Compare group
• Carolina Pulmonary & Sleep Disorder, LLC

  dba Abbas Mansour 'DBA' Carolina Pulmonary & Sleep Disorder

  • Pulmonary Disease Physician
  • Easley, SC
  • NPI 1598903528
  Medicare reassignment
• Greenville Health System

  dba GHS Cardiovascular SVCS Simp

  • General Acute Care Hospital
  • Simpsonville, SC
  • NPI 1679992838
  NPD (past)

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1023046380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603725",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603725",
            "telephone_number": "828-575-2625",
            "fax_number": "828-350-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 E BUTLER RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075910",
            "telephone_number": "864-627-3800",
            "fax_number": "864-672-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "JENIFER",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "930",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "PA930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AA06356910",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0287PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Pete
• Peter G Manos MD LLC
• Diana Elizabeth Peterman, MD
• Caitlin Anne Peters, CP
• Elizabeth Peters, APRN
• Richard Petersen, CRNA
• Valarie Anne Petersen, APRN, BC
• Catherine Michelle Peterson, PSY.D.
• Christopher Morrison Peterson, MD
• Hannah Peterson, PT, DPT

• Physician Assistant in Greenville, SC
• Providers in Greenville, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.