Active NPI
Daniel Scott Petersen, ARNP
- Family Nurse Practitioner
- Bremerton, WA
National Provider Identifier
1083819858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP60408146
- Practice address
- 5455 Almira Dr SE
Bremerton, WA 98311-8330 - Phone
- (360) 373-5031
- Fax
- (360) 478-0851
- NPI assigned
- Jun 20, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | RC00048583 | WA | |
| Family Nurse Practitioner | 363LF0000X | AP60408146 | WA | Primary |
Addresses
Primary practice location
5455 Almira Dr SE
Bremerton, WA 98311-8330
Mailing address
5455 Almira Dr SE
Bremerton, WA 98311-8330
Phone (360) 373-5031
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RC00048583 | WA | MD | Mental Health Counselor |
| AP60408146 | WA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450137600000",
"number": "1083819858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5455 ALMIRA DR SE",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983118330",
"telephone_number": "360-373-5031",
"fax_number": "360-478-0851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5455 ALMIRA DR SE",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983118330",
"telephone_number": "360-373-5031",
"fax_number": "360-478-0851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "DANIEL",
"middle_name": "SCOTT",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-20",
"last_updated": "2015-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "RC00048583",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "AP60408146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bremerton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.