Individual provider Active NPI

Sarah Repp Peterson, A.N.P.

  • Nurse Practitioner
  • Ann Arbor, MI
National Provider Identifier
1033279369
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704222519 Issued in MI
Practice address
4260 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone
(734) 763-6295
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 4704222519 MI
Nurse Practitioner 363L00000X 4704222519 MI Primary

Addresses

Primary practice location

4260 Plymouth Rd
Ann Arbor, MI 48109-2700

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

14650 E Old US Highway 12
Suite 101
Chelsea, MI 48118-1801
Phone (734) 475-3979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20110131000540 MI Practitioner - Nurse Practitioner 2567641061 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4000

4260 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone (734) 647-5650

4270 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone (734) 232-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704222519MIMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan CurrentSince Jan 11, 2022 Accepting new patients
Iha Health Service Corporation CurrentSince Jul 15, 2017 Accepting new patients
Chelsea Community Hospital CurrentSince Jun 19, 2019 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Regents of the University of Michigan Nurse Practitioner CurrentSince Jan 11, 2022 Accepting new patients
Chelsea Community Hospital CurrentSince Jun 19, 2019 Accepting new patients
Iha Health Services Corporation CurrentSince Jul 15, 2017 Accepting new patients

Locations

4260 Plymouth Rd
Ann Arbor, MI 48109
Phone (734) 647-5715

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1515 Commerce Park Dr
Chelsea, MI 48118
Phone (734) 475-4190

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

14650 E Old US Highway 12
Ste 104
Chelsea, MI 48118
Phone (734) 593-5700

14650 E Old US Highway 12
Ste 101
Chelsea, MI 48118
Phone (734) 475-3979

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

Interoperability endpoints

  • Direct secure messaging: speterson44834@direct.trinity-health.org

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1033279369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4260 PLYMOUTH RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481092700",
            "telephone_number": "734-763-6295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14650 E Old US Highway 12",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Chelsea",
            "state": "MI",
            "postal_code": "481181801",
            "country_code": "US",
            "telephone_number": "734-475-3979",
            "fax_number": "734-433-4513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SARAH",
        "middle_name": "REPP",
        "name_prefix": "Mrs.",
        "credential": "A.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MI",
            "license": "4704222519",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704222519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.