Kenneth S Peterson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN192039 Issued in MA

Practice address

70 Highland St Ste 1
Worcester, MA 01609-2730

Phone

(508) 715-6372

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, 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.

• Unity Family Health LLC

  • Primary Care Clinic/Center
  • Worcester, MA
  • NPI 1609602770
  NPD Authorized official

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1194744896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 HIGHLAND ST STE 1",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016092730",
            "telephone_number": "508-847-6546",
            "fax_number": "508-433-9785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 HIGHLAND ST STE 1",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016092730",
            "telephone_number": "508-715-6372"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 Queen St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "01610",
            "country_code": "US",
            "telephone_number": "508-860-7800",
            "fax_number": "508-860-7973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KENNETH",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN192039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0322938",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danna B. Peterson, MD
• Ellen W Peterson, FAMILY NP
• Frances Peterson, LMHC
• Gary Peterson
• Karin E Peterson, LICSW
• Kristen Peterson
• Laura Lynne Peterson, MD
• Nathan Y Peterson, L.M.H.C.
• Noah Marek Peterson, PSYD
• Jean Sergot Petion Sr., M.ED

• Family Nurse Practitioner in Worcester, MA
• Providers in Worcester, MA by specialty
• Family Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.