Active NPI
Nancy Anne Peterson, PA-C
- Physician Assistant
- Boulder, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA.0001107
- Practice address
- 5495 Arapahoe Ave Ste 100
Boulder, CO 80303-1224 - Phone
- (303) 415-4250
- Fax
- (303) 440-9629
- NPI assigned
- Jan 11, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA.0001107 | CO | Primary |
Addresses
Primary practice location
5495 Arapahoe Ave Ste 100
Boulder, CO 80303-1224
Mailing address
5450 Western Ave
Boulder, CO 80301-2709
Phone (303) 415-4250
Other names 1
- Ms. Nancy Anne King
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1755 48TH St
Suite 200
Boulder, CO 80301-2712
Phone (303) 415-7450
5495 Arapahoe Ave
Boulder, CO 80303-1224
Hospital & facility affiliations
- Boulder Community Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1107 | CO | MD | Optometrist |
| PA.0001107 | CO | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boulder Community Health | Current | Accepting new patients | |
| Boulder Community Health | Current | Accepting new patients | |
| Boulder Community Health | Past | Accepting new patients | |
| Boulder Community Health | Past | Accepting new patients |
Locations
6685 Gunpark Dr
Ste 110
Boulder, CO 80301
Phone (303) 415-7599
5450 Western Ave
Boulder, CO 80301
Phone (303) 415-4770
1645 Broadway
Boulder, CO 80302
Phone (303) 415-8900
1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450
5495 Arapahoe Ave
Ste 100
Boulder, CO 80303
Phone (303) 415-4250
Organizations & group practices 5
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.
-
- General Acute Care Hospital
- Boulder, CO
- NPI 1821074196
-
- Primary Care Clinic/Center
- Boulder, CO
- NPI 1740837137
-
- Medical Specialty Clinic/Center
- Boulder, CO
- NPI 1790332187
-
- Medical Specialty Clinic/Center
- Boulder, CO
- NPI 1407685498
-
- Multi-Specialty Clinic/Center
- Boulder, CO
- NPI 1609822030
Hospital & facility affiliations 34
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Sleep Disorder Diagnostic Clinic/Center
- Boulder, CO
- NPI 1093357907
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557446400000",
"number": "1083764252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5450 WESTERN AVE",
"city": "BOULDER",
"state": "CO",
"postal_code": "803012709",
"telephone_number": "303-415-4250",
"fax_number": "303-440-9629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5495 ARAPAHOE AVE STE 100",
"city": "BOULDER",
"state": "CO",
"postal_code": "803031224",
"telephone_number": "303-415-4250",
"fax_number": "303-440-9629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "NANCY",
"middle_name": "ANNE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-11",
"last_updated": "2019-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "PA.0001107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NANCY",
"last_name": "KING",
"middle_name": "ANNE",
"prefix": "MS.",
"credential": "PAC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2019; 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.