Active NPI
Pamela Teresa Peterson, NP
- Acute Care Nurse Practitioner
- Jackson, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 4704194081
- Practice address
- 300 W Washington Ave
Suite 300
Jackson, MI 49201-2180 - Phone
- (517) 841-1305
- Fax
- (517) 841-1306
- NPI assigned
- Jun 7, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704194081 | MI | |
| Acute Care Nurse Practitioner | 363LA2100X | 4704194081 | MI | Primary |
Addresses
Primary practice location
300 W Washington Ave
Suite 300
Jackson, MI 49201-2180
Mailing address
PO Box 670884
Detroit, MI 48267-0884
Phone (800) 999-5829
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255371530 | Medicaid | MI | |
| P00252787 | Other | MI | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
205 N E Ave
Henry Ford Allegiance Health
Jackson, MI 49201-1753
Phone (517) 205-4800
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospitalist Medicine Physicians of Michigan, PLLC | Current | Accepting new patients | |
| W.a. Foote Memorial Hospital, Inc | Nurse Practitioner | Current | Accepting new patients |
| Hospitalist Medicine Physicians of Michigan PLLC | Current | Accepting new patients | |
| Sound Inpatient Physicians - Michigan, PLLC | Current | Accepting new patients | |
| Sound Inpatient Physicians-Michigan, PLLC | Nurse Practitioner | Current | Accepting new patients |
| Degara App, PLLC | Nurse Practitioner | Current | Accepting new patients |
| Sound Inpatient Physicians-Michigan PLLC | Current | Accepting new patients | |
| MVC CT | Past | Accepting new patients | |
| Wa Foote Memorial Hospital, Inc | Past | Accepting new patients | |
| Cogent Healthcare of Michigan PC | Nurse Practitioner | Past | Accepting new patients |
| MVC Az | Past | Accepting new patients | |
| Anchor Health Centers PA | Past | Accepting new patients |
Locations
818 Riverside Ave
Adrian, MI 49221
Phone (517) 263-0711
1721 S Stephenson Ave
Iron Mountain, MI 49801
Phone (906) 776-5415
205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730
300 W Washington Ave
Ste 300
Jackson, MI 49201
Phone (517) 205-1305
401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286
1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591
1465 E Parkdale Ave
Manistee, MI 49660
Phone (231) 398-1000
580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131
50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300
7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580
200 Hemlock St
Tawas City, MI 48763
Phone (989) 362-0153
500 E Pottawatamie St
Tecumseh, MI 49286
Phone (517) 266-0525
1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000
Interoperability endpoints
- ppeterson456453@direct.hfhs.org
Organizations & group practices 13
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.
-
- Nurse Practitioner
- Jackson, MI
- NPI 1629000708
-
- Internal Medicine Physician
- Adrian, MI
- NPI 1013180181
-
- Internal Medicine Physician
- Kalamazoo, MI
- NPI 1093967861
Nurse Practitioner
-
- Internal Medicine Physician
- Adrian, MI
- NPI 1033370283
-
- Hospitalist Physician
- Escanaba, MI
- NPI 1366768178
-
- Internal Medicine Physician
- Grayling, MI
- NPI 1639311996
-
- Nurse Practitioner
- Jackson, MI
- NPI 1366988347
-
- Internal Medicine Physician
- Jackson, MI
- NPI 1295047165
Nurse Practitioner
-
- Emergency Medicine Physician
- Jackson, MI
- NPI 1265487722
-
- Family Medicine Physician
- Naples, FL
- NPI 1174571608
-
- Surgery Physician
- Phoenix, AZ
- NPI 1477256063
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jackson, MI
- NPI 1053403402
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757289600000",
"number": "1255371530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 670884",
"city": "DETROIT",
"state": "MI",
"postal_code": "482670884",
"telephone_number": "800-999-5829",
"fax_number": "248-641-4840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W WASHINGTON AVE",
"address_2": "SUITE 300",
"city": "JACKSON",
"state": "MI",
"postal_code": "492012180",
"telephone_number": "517-841-1305",
"fax_number": "517-841-1306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "PAMELA",
"middle_name": "TERESA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-07",
"last_updated": "2025-09-08",
"certification_date": "2025-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704194081",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "MI",
"license": "4704194081",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1255371530",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00252787",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.
- 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.