Peterson Family Healthcare

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APN11999 Issued in TN

Legal business name

PETERSON FAMILY HEALTHCARE

Practice address

1201 N Main Ave Ste 3
Erwin, TN 37650-9102

Phone

(423) 341-0629

NPI assigned

Sep 10, 2010

Last updated

Sep 10, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shanna B Peterson, FNPNPI 1295781045

Title

Sole Member

Phone

(423) 341-0629

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shanna B Peterson, FNP

  • Nurse Practitioner
  • Erwin, TN
  • NPI 1295781045
  NPD Authorized official

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

{
    "created_epoch": "1284076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284076800000",
    "number": "1225345275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 716",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376500716",
            "telephone_number": "423-341-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N MAIN AVE STE 3",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376509102",
            "telephone_number": "423-341-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSON FAMILY HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-10",
        "last_updated": "2010-09-10",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "SHANNA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "423-341-0629",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN11999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylee Breanne Nicholson
• Nolachucky Medical
• Sara Jean O'Daniel, DMD
• Victoria Lynn Osborne, F.N.P.
• Amy M Perkins, PHARMD
• Mark Peterson, PT
• Shanna B Peterson, FNP
• Christopher Phillips, PT
• Pioneer Medical Associates, PC
• Ashley Danielle Powell

• Nurse Practitioner in Erwin, TN
• Providers in Erwin, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.