Nina Escobar Petersen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2014008259 Issued in MO

Practice address

1535 NE Rice Rd
Lees Summit, MO 64086-5849

Phone

(816) 966-0900

Fax

(816) 347-3209

NPI assigned

Mar 30, 2010

Last updated

May 11, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25804/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: nina.petersen.1@25804.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rediscover

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lee's Summit, MO
  • NPI 1841235298
  Medicare reassignment NPD
• Regional Health Care Clinic Inc

  dba Katy Trail Community Health

  • Federally Qualified Health Center (FQHC)
  • Sedalia, MO
  • NPI 1922057504
  Medicare reassignment NPD
• Regional Health Care Clinic, Inc

  dba Katy Trail - Prairie Hills

  • Federally Qualified Health Center (FQHC)
  • Versailles, MO
  • NPI 1053694422
  Medicare reassignment NPD
• The Children's Mercy Hospital

  • Pediatrics Physician
  • Kansas City, MO
  • NPI 1851437719
  Medicare reassignment NPD
• Rediscover

  • Methadone Clinic
  • Kansas City, MO
  • NPI 1659749414
  NPD
• Regional Health Care Clinic, Inc

  dba Katy Trail - Warsaw School

  • Federally Qualified Health Center (FQHC)
  • Warsaw, MO
  • NPI 1629797196
  NPD
• The Children's Mercy Hospital

  dba Children's Mercy Riverside Pharmacy - Mail

  • Mail Order Pharmacy
  • Riverside, MO
  • NPI 1235923194
  NPD
• Children's Mercy-Community Choice Pediatrics

  • Pediatrics Physician
  • Lee's Summit, MO
  • NPI 1114540085
  NPD (past)
• Psychiatry Associates of Kansas City PA

  • Psychiatry Physician
  • Leawood, KS
  • NPI 1356321947
  NPD (past)

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1093030389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 NE RICE RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865849",
            "telephone_number": "816-347-3069",
            "fax_number": "816-347-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 NE RICE RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865849",
            "telephone_number": "816-966-0900",
            "fax_number": "816-347-3209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 W 4th St",
            "address_purpose": "LOCATION",
            "city": "Sedalia",
            "state": "MO",
            "postal_code": "653014247",
            "country_code": "US",
            "telephone_number": "660-620-8251",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1806 W 11th St Ste B",
            "address_purpose": "LOCATION",
            "city": "Sedalia",
            "state": "MO",
            "postal_code": "653015159",
            "country_code": "US",
            "telephone_number": "660-530-3086",
            "fax_number": "660-530-3086",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "214 NE Chipman Rd",
            "address_purpose": "LOCATION",
            "city": "Lees Summit",
            "state": "MO",
            "postal_code": "64063",
            "country_code": "US",
            "telephone_number": "660-530-3086",
            "fax_number": "660-530-3086",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "410C SE 3rd St Ste 108",
            "address_purpose": "LOCATION",
            "city": "Lees Summit",
            "state": "MO",
            "postal_code": "640632849",
            "country_code": "US",
            "telephone_number": "660-530-3086",
            "fax_number": "660-530-3086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESCOBAR PETERSEN",
        "first_name": "NINA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-30",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2014008259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD - BLUE KC",
            "identifier": "50560039",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa M Erickson, LCSW
• Erin Neill Bromley, DDS
• Craig A Erisman, PSY.D.
• Dawn A. Ertel, O.D.
• Alexander Ervin
• Kaylyn Eshraghi
• Abigail Kathryn Eskew, RD, LD
• Essential Chiropractic LLC
• Stacey Anne Estes- Juve, APRN
• Maci Louise Estes, FNP-BC

• Clinical Social Worker in Lee's Summit, MO
• Providers in Lee's Summit, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.