Melissa Jo Peterson, NP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5010247 Issued in NC

Practice address

3404 Wake Forest Rd
Raleigh, NC 27609-7340

Phone

(919) 862-5400

NPI assigned

Feb 8, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1518048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1023517745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3404 WAKE FOREST RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3404 WAKE FOREST RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097340",
            "telephone_number": "919-862-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MELISSA",
        "middle_name": "JO",
        "credential": "NP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-08",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5010247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jada Peterson
• James Jerry Peterson III, BA.
• James Wilson Peterson, M.D.
• Kelcey Peterson
• Kirk Darrel Peterson, M.D.
• Seth Peterson
• Stephen Paul Peterson, MD
• Alexandra Michelle Petraszko, D.D.S.
• Dana Marie Petre
• Daniel J Petrocella, DDS, PA

• Family Nurse Practitioner in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; 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.