Individual provider Active NPI

Peter James Nilsson, DO

  • Infectious Disease Physician
  • Columbia, MO
National Provider Identifier
1104347046
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
2022031264 Issued in MO
Practice address
One Hospital Dr
Columbia, MO 65212-0001
Phone
(573) 884-9066
Fax
(573) 884-3037
NPI assigned
Jun 30, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 2022031264 MO
Internal Medicine Physician 207R00000X 2022031264 MO
Infectious Disease Physician 207RI0200X 2022031264 MO Primary

Addresses

Primary practice location

One Hospital Dr
Columbia, MO 65212-0001

Mailing address

PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 884-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220923002664 MO Practitioner - Infectious DiseasePractitioner - Internal MedicinePractitioner - Hospitalist 4284904665 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Hospitalist, Internal Medicine
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

1 Hospital Dr
Columbia, MO 65212-0001
Phone (573) 882-4141

1600 E Broadway
Columbia, MO 65201-5844
Phone (573) 815-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Boone Physician Services, LLC CurrentSince Mar 27, 2023 Accepting new patients
The Curators of the University of Missouri CurrentSince Aug 10, 2022 Accepting new patients
Curators of the University of Missouri CurrentSince Aug 10, 2022 Accepting new patients
Curators of the University of Missouri Past Accepting new patients

Locations

1705 E Broadway
Ste 300
Columbia, MO 65201
Phone (573) 449-9355

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1 Hospital Dr
#4300
Columbia, MO 65212
Phone (573) 884-1606

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

1100 Virginia Ave
Columbia, MO 65212
Phone (573) 882-2663

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1104347046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE HOSPITAL DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652120001",
            "telephone_number": "573-884-9066",
            "fax_number": "573-884-3037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILSSON",
        "first_name": "PETER",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-30",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2022031264",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2022031264",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MO",
            "license": "2022031264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.