Edith C Peterson, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F-302355 Issued in NY

Practice address

1424 Genesee St
Utica, NY 13502-5101

Phone

(315) 724-6146

Fax

(315) 797-9671

NPI assigned

Oct 4, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1043305956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 STATE ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123071508",
            "telephone_number": "518-374-5353",
            "fax_number": "518-347-1413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025101",
            "telephone_number": "315-724-6146",
            "fax_number": "315-797-9671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "EDITH",
        "middle_name": "C",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "371556",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F-302355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "346874",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karina Lea Perry
• Michael Joseph Perry, PMHNP
• Melissa Ann Peruzzi, AGNP
• Allison Marie Peters, PA
• Taylor Kristine Peters, LMSW
• Russell Petrie, PA-C
• Robert C Petronio Jr., RPH
• Judith Arden Petroski, LSWR
• Karina Petrovets
• Viktor Ivanovich Petrovets, FNP-BC

• Adult Health Nurse Practitioner in Utica, NY
• Providers in Utica, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.