Individual provider Active NPI

Kendall Kristine Peterson, APRN- NP

  • Acute Care Nurse Practitioner
  • Lincoln, NE
National Provider Identifier
1134857360
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
114336 Issued in NE
Practice address
2222 S 16TH St Ste 405
Lincoln, NE 68502-3793
Phone
(402) 481-1111
NPI assigned
Aug 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 114336 NE Primary

Addresses

Primary practice location

2222 S 16TH St Ste 405
Lincoln, NE 68502-3793

Mailing address

2222 S 16TH St Ste 405
Lincoln, NE 68502-3793
Phone (402) 750-3018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20221003002363 NE Practitioner - Nurse Practitioner 0547646283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient Physician Associates, LLCGroup PAC ID 2365334364, 76 clinicians

Practice addresses (Care Compare)

2300 S 16TH St
Lincoln, NE 68502-3704
Phone (402) 475-1011

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
114336NEMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Physician Associates, LLC CurrentSince Jun 13, 2023 Accepting new patients

Locations

1600 S 48th St
Lincoln, NE 68506
Phone (402) 481-9049

2300 S 16th St
Lincoln, NE 68502
Phone (402) 434-6042

Organizations & group practices 1

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 3

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": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1134857360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 S 16TH ST STE 405",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023793",
            "telephone_number": "402-750-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 S 16TH ST STE 405",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023793",
            "telephone_number": "402-481-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KENDALL",
        "middle_name": "KRISTINE",
        "name_prefix": "Mrs.",
        "credential": "APRN- NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NE",
            "license": "114336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.