Ann Peterson, NP

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

RN86754 Issued in MA

Practice address

2 Daly Rd
Medford, MA 02155-3702

Phone

(781) 393-8833

NPI assigned

Jul 12, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342051200000",
    "number": "1104181445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 DALY RD",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021553702",
            "telephone_number": "781-393-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DALY RD",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021553702",
            "telephone_number": "781-393-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-12",
        "last_updated": "2012-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MA",
            "license": "RN86754",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CT",
            "license": "067490",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NH",
            "license": "046055-21",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "067490",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "RN86754",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "046055-21",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristianna Penman, MSW
• Jessica Pepin, RN, CNP
• Rachel Arielle Perla, M.D.
• Perrotta Dental, LLC
• James C Pert, M.D.
• Christina Peterson, MSW, LICSW
• David M Petrarca, D.D.S.
• Teresia T Pham, MD
• James Melvin Phillips
• Jeffrey W Phillips, M.D.

• All providers in Medford, MA
• General Practice Registered Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; 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.