Individual provider Active NPI

Jessica Kaur Peters, NP

  • Adult Health Nurse Practitioner
  • West Bloomfield, MI
National Provider Identifier
1124465257
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704256147 Issued in MI
Practice address
6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone
(248) 325-1000
NPI assigned
May 30, 2013
Last updated
Jul 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 4704256147 MI
Adult Health Nurse Practitioner 363LA2200X 4704256147 MI Primary

Addresses

Primary practice location

6777 W Maple Rd
West Bloomfield, MI 48322-3013

Mailing address

1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (313) 874-4806

Other practice location 1

23900 Orchard Lake Rd
Farmington Hills, MI 48336-2501
Phone (248) 427-7135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140917000569 MI Practitioner - Nurse Practitioner 0143449512 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 661-4100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704256147MIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Nurse Practitioner CurrentSince May 6, 2022 Accepting new patients
Cardioq Heart and Vascular Specialists of Mi CurrentSince Dec 1, 2018 Accepting new patients
Palliative Coach Michigan CurrentSince Feb 4, 2024 Accepting new patients
Ark Multispecialty Physicians PLLC CurrentSince Sep 1, 2021 Accepting new patients
Primary Telemed Services Current Accepting new patients
Henry Ford Health System CurrentSince May 6, 2022 Accepting new patients
Palliative Coach Adult Health PastSince Jul 16, 2023 Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

32804 Pierce St
Beverly Hills, MI 48025
Phone (248) 540-9866

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-4806

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

468 Cadieux Rd
Grosse Pointe Woods, MI 48230
Phone (313) 343-1000

26631 Southfield Rd
Lathrup Village, MI 48076
Phone (248) 552-8195

17177 N Laurel Park Dr
Ste 439
Livonia, MI 48152

3601 W 13 Mile Rd
Royal Oak, MI 48073

25130 Southfield Rd
Ste 105
Southfield, MI 48075
Phone (248) 234-6790

25130 Southfield Rd
Ste 120
Southfield, MI 48075
Phone (248) 234-6790

25130 Southfield Rd
Ste 230
Southfield, MI 48075
Phone (248) 234-6790

27207 Lahser Rd
Ste 200B
Southfield, MI 48034
Phone (248) 663-1900

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Interoperability endpoints

  • Direct secure messaging: juppal@direct.dmc.org
  • Direct secure messaging: juppal793924@direct.hfhs.org

Organizations & group practices 9

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.

Hospital & facility affiliations 2

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": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1124465257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6777 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223013",
            "telephone_number": "248-325-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23900 Orchard Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483362501",
            "country_code": "US",
            "telephone_number": "248-427-7135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "JESSICA",
        "middle_name": "KAUR",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-30",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "MI",
            "license": "4704256147",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704256147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.