Ericka Leslie Petersen, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CP001145 Issued in SD

Practice address

100 Mac LN
Pierre, SD 57501-3391

Phone

(605) 224-5901

NPI assigned

Oct 4, 2016

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

Enrolled in SD

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

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avera St MarysGroup PAC ID 0143134965, 97 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Avera @ Home Home health agency, Pierre, SD, CCN 437046
• Avera St Mary's Hospital Hospital, Pierre, SD, CCN 430015

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ericka.petersen@avera.sdhealthlink.net

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.

• Avera St Marys

  dba Avera St. Mary's Hospital

  • General Acute Care Hospital
  • Pierre, SD
  • NPI 1669457180
  Medicare reassignment Care Compare group NPD
• Avera St Marys

  dba Avera St Marys Hospital ER CRNA

  • Emergency Medicine Physician
  • Pierre, SD
  • NPI 1073305496
  NPD
• Avera St Marys

  dba Avera Pierre Clinic

  • Multi-Specialty Clinic/Center
  • Pierre, SD
  • NPI 1720326713
  NPD
• Avera McKennan

  dba Avera Medical Group Spencer

  • Family Medicine Physician
  • Spencer, IA
  • NPI 1902886567
  NPD (past)

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

• Avera at Home

  dba Avera@Home

  • Home Health Agency
  • Pierre, SD
  • NPI 1336579127
  Care Compare affiliation
• Avera St Marys

  dba Avera St. Mary's Hospital

  • General Acute Care Hospital
  • Pierre, SD
  • NPI 1669457180
  Care Compare affiliation
• Avera St Marys

  dba Avera Pierre Clinic

  • Multi-Specialty Clinic/Center
  • Pierre, SD
  • NPI 1720326713

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1073063905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MAC LN",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575013391",
            "telephone_number": "605-224-5901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAC LN",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575013391",
            "telephone_number": "605-224-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "ERICKA",
        "middle_name": "LESLIE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP001145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ulises Jorge Pesce, PSYCHIATRIST
• Leonard James Petrik, PHARM. D.
• Margaret Ann Pier, LPC
• Rachal Pierce, AUD
• Pierre Care and Rehabilitation Center LLC (Pierre Care and Rehabilitation Center)
• Pierre Dental Clinic Prof LLC (Pierre Dental Clinic)

• Family Nurse Practitioner in Pierre, SD
• Providers in Pierre, SD by specialty
• Family Nurse Practitioner in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; 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.