Evelyn Peterson, MD

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

2005007776 Issued in MO

Practice address

350 Sunnyview LN
Kalispell, MT 59901-3129

Phone

(406) 752-5111

Fax

(406) 756-2703

NPI assigned

Apr 10, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Lyn Peterson Other name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: krmcmedicalrecords@krhdirect.org
• Direct secure messaging: evelynpeterson@mhccaremail.com

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.

• Kalispell Regional Medical Center Inc

  dba Logan Health Medical Center

  • General Acute Care Hospital
  • Kalispell, MT
  • NPI 1417945627
  Medicare reassignment
• Kalispell Regional Medical Center Inc

  dba Logan Health Breast Center

  • Clinic/Center
  • Kalispell, MT
  • NPI 1235333139
  NPD
• Kalispell Regional Medical Center Inc

  dba Logan Health Neuroscience & Spine

  • Neurology Physician
  • Kalispell, MT
  • NPI 1295006070
  NPD
• Kalispell Regional Medical Center, Inc

  dba Logan Health Imaging- 1111 Baker

  • Radiology Clinic/Center
  • Whitefish, MT
  • NPI 1073362463
  NPD
• DLP Marquette General Hospital LLC

  dba UP Health System Marquette

  • General Acute Care Hospital
  • Marquette, MI
  • NPI 1568727048
  NPD (past)

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1306809520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 SUNNYVIEW LN",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013129",
            "telephone_number": "406-752-5111",
            "fax_number": "406-756-2703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 SUNNYVIEW LN",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013129",
            "telephone_number": "406-752-5111",
            "fax_number": "406-756-2703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Sunnyview Ln",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013129",
            "country_code": "US",
            "telephone_number": "406-751-5391",
            "fax_number": "406-751-2988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "EVELYN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "ID",
            "license": "M-8305",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CO",
            "license": "43861",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MO",
            "license": "2005007776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "address_1": "350 Sunnyview Ln",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "address_1": "310 Sunnyview Ln",
            "address_2": "OB Dept",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LYN",
            "last_name": "PETERSON",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dawn Peters, N.P.
• Haley C Peters, FNP-BC
• Shianna Peters, MS, RN
• Sonia Lynn Petersen, OT
• Dennis Lee Peterson, M.D.
• Becky Ann Petrashek, RN
• Jaime Petro, DPT
• Lana J Pettit, LAC
• Phebe Titus Lime, PHD, PLLC
• Mallory Phillips, MSW

• Neonatal-Perinatal Medicine Physician in Kalispell, MT
• Providers in Kalispell, MT by specialty
• Neonatal-Perinatal Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.