Active NPI
Sarah J Peterson, RD
- Registered Dietitian
- Jackson, WY
National Provider Identifier
1194196667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1016333
- Practice address
- 555 E Broadway Ave
Ste 201
Jackson, WY 83001-8640 - Phone
- (307) 739-7634
- Fax
- (307) 739-7632
- NPI assigned
- Oct 9, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1016333 | WY | Primary |
Addresses
Primary practice location
555 E Broadway Ave
Ste 201
Jackson, WY 83001-8640
Mailing address
PO Box 428
Jackson, WY 83001-0428
Phone (307) 739-7634
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 143782800 | Medicaid | WY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | speterson@sjmc.cernerdirect.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
625 E Broadway Ave
Jackson, WY 83001-8642
Phone (307) 733-3636
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.82 of 100
- Quality
- 67.1
- Promoting interoperability
- 98
- Improvement activities
- 40
- Cost
- 73.98
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1016333 | WY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teton County Hospital District | Current | Accepting new patients |
Interoperability endpoints
- speterson@sjmc.cernerdirect.com
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.
-
- General Practice Physician
- Jackson, WY
- NPI 1487818605
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613520000000",
"number": "1194196667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 428",
"city": "JACKSON",
"state": "WY",
"postal_code": "830010428",
"telephone_number": "307-739-7634",
"fax_number": "307-739-7632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 E BROADWAY AVE",
"address_2": "STE 201",
"city": "JACKSON",
"state": "WY",
"postal_code": "830018640",
"telephone_number": "307-739-7634",
"fax_number": "307-739-7632"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "SARAH",
"middle_name": "J",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-09",
"last_updated": "2021-02-17",
"certification_date": "2021-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WY",
"license": "1016333",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "143782800",
"state": "WY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "speterson@sjmc.cernerdirect.com",
"affiliation": "N",
"endpointDescription": "Direct Messaging Address for St John's Health",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Other",
"address_1": "555 E Broadway Ave",
"address_2": "Ste 201",
"city": "Jackson",
"state": "WY",
"country_code": "US",
"postal_code": "830018640",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Jackson, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.