Carolyn Marie Peters, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F09191394 Issued in MS

Practice address

10236 Little Gem Dr
Gulfport, MS 39503-8357

Phone

(228) 365-5020

NPI assigned

Dec 6, 2019

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• TBD Acquisition II LLC

  • Psychiatric Hospital
  • Gulfport, MS
  • NPI 1750891792
  NPD
• TBD Acquisition II, LLC

  • Clinical Social Worker
  • Gulfport, MS
  • NPI 1003324419
  NPD

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

{
    "created_epoch": "1575590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1154968394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10236 LITTLE GEM DR",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395038357",
            "telephone_number": "228-365-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10236 LITTLE GEM DR",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395038357",
            "telephone_number": "228-365-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "CAROLYN",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-06",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "F09191394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Penny, SLP
• Pensacola Health Trust Inc
• Roy D Pepper Jr., DC
• Perez Vision Clinic
• Jeffrey J Perez, O.D.
• Carolyn Patricia Peters, OTR/L
• Jaren Peters, RBT
• Darlene Ann Petersen, NP
• Maria C Peterson, PCMHT
• PFD LLC

• Family Nurse Practitioner in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.