Braden Peterson, APRN-CNP
Individual provider Active NPI Family Nurse Practitioner · Blanchard, OK
NPI 1245762020 · NPPES record last updated Mar 6, 2026
Key facts
- NPI
- 1245762020
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 90405 (OK)
- Practice address
- 217 N Harrison Ave Ste 109
Blanchard, OK 73010-6217 - Phone
- (405) 888-8483
- Fax
- (918) 803-4861
- NPI assigned
- Mar 30, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Peterson Healthcare LLC
Trucare Pain Management LLC
Practice addresses (Care Compare)
217 N Harrison Ave
Suite 109
Blanchard, OK 73010-6217
Phone (405) 888-8483
9220 S Pennsylvania Ave
Suite a
Oklahoma City, OK 73159-6909
Phone (405) 703-8860
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170510002622 | OK | Practitioner - Nurse Practitioner | 0941587430 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 90405 | OK | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peterson Healthcare LLC | Current |
Accepting new patients | |
| Trucare Pain Management LLC | Current |
Accepting new patients | |
| Sunnylane Medical Clinic LLC | Current |
Accepting new patients | |
| Sunnylane Medical Clinic | Past | Accepting new patients |
Locations
217 N Harrison Ave
Ste 109
Blanchard, OK 73010
Phone (405) 266-0761
217 N Harrison Ave
Blanchard, OK 73010
Phone (405) 888-8483
9220 S Pennsylvania Ave
Ste A
Oklahoma City, OK 73159
Phone (405) 691-2838
215 N Midwest Blvd
Oklahoma City, OK 73110
Phone (405) 455-5330
3916 S Sunnylane Rd
Oklahoma City, OK 73115
Phone (405) 677-3378
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/GDHHCD/Endpoint/GDHHCD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 90405 | OK | Yes |
Addresses
Primary practice location
217 N Harrison Ave Ste 109
Blanchard, OK 73010-6217
Mailing address
217 N Harrison Ave Ste 109
Blanchard, OK 73010-6217
Phone (405) 888-8483
Other practice location 1
3916 S Sunnylane Rd
Del City, OK 73115-3656
Phone (405) 677-3378
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200701320A | Medicaid | OK |
Other providers in Blanchard, OK
- Orthopaedic and Sports Medicine Center-Norman, P.C.
- Ashley Owens
- Katie Rae Owings
- Peterson Healthcare LLC
- Peterson Medical LLC
- Pharm Blanchard Acquisition LLC
- Ediejo Placencio
- Maria L Plata
- Amy Plott
- Skye Whitney Powers
All providers in Blanchard, OK · Family Nurse Practitioner in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.