Judy Lynn Petermann, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AO1621 Issued in AR

Practice address

1100 N College Ave
Fayetteville, AR 72703-1944

Phone

(479) 443-4301

Fax

(479) 587-5822

NPI assigned

Jul 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Mercy Health Northwest Arkansas Communities

  • Multi-Specialty Clinic/Center
  • Rogers, AR
  • NPI 1265490916
  NPD (past)

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1114948056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3885 TARA ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727627947",
            "telephone_number": "479-466-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N COLLEGE AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031944",
            "telephone_number": "479-443-4301",
            "fax_number": "479-587-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERMANN",
        "first_name": "JUDY",
        "middle_name": "LYNN",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "AO1621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Dylan Perry, PTA
• Kim Smith Perry
• Ashlyn Perryman, LCSW
• Dennis Dean Perryman, D.O.
• Mary H Peter, LPTA
• Britton Peters
• Brent P Peterson, DO
• Emily Peterson, O.D
• Micah Peterson
• Rachel Ann Peterson, M.S., L.A.C

• Family Nurse Practitioner in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.