Individual provider Active NPI

Tereza J Peercy, APRN

  • Women's Health Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1275003519
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
3012837 Issued in KY
Practice address
350 Evergreen Rd # 108
Louisville, KY 40243-1010
Phone
(502) 777-0203
NPI assigned
Nov 29, 2018
Last updated
Aug 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 3012837 KY Primary

Addresses

Primary practice location

350 Evergreen Rd # 108
Louisville, KY 40243-1010

Mailing address

350 Evergreen Rd # 108
Louisville, KY 40243-1010
Phone (502) 777-0203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20181221000797 KY Practitioner - Nurse Practitioner 3779828694 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Dec 29, 2021 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Dec 29, 2021 Accepting new patients
Joseph Mull Counseling Services Past Accepting new patients

Locations

3 Audubon Plaza Dr
Ste 110
Louisville, KY 40217
Phone (502) 367-8121

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

3940 DuPont Cir
Louisville, KY 40207
Phone (502) 895-1111

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1275003519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 EVERGREEN RD # 108",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402431010",
            "telephone_number": "502-777-0203",
            "fax_number": "502-917-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 EVERGREEN RD # 108",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402431010",
            "telephone_number": "502-777-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEERCY",
        "first_name": "TEREZA",
        "middle_name": "J",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-29",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "KY",
            "license": "3012837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.