Nannette Marie Petersen, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS7768 Issued in FL

Practice address

279 N Grove Medical Park Dr
Spartanburg, SC 29303-4222

Phone

(864) 582-7025

Fax

(864) 583-5715

NPI assigned

Aug 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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 Osteopathy

State licenses

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490313600000",
    "number": "1336152586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 RABON VALLEY ACRES RD",
            "city": "FOUNTAIN INN",
            "state": "SC",
            "postal_code": "296448605",
            "telephone_number": "864-582-7025",
            "fax_number": "864-583-5715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 N GROVE MEDICAL PARK DR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293034222",
            "telephone_number": "864-582-7025",
            "fax_number": "864-583-5715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "NANNETTE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2017-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS7768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Perry, PA-C
• Perspectives Counseling Services, LLC
• Jennifer Lynn Perugini, MD
• Brady Michael Peters
• Kathryn Petersen-Thompson, DO
• Brad Edward Peterson, LISW-CP
• Susan Grizzard Peterson, N.P.
• Martha Deschamps Petoskey, PH.D.
• Alexa Petriella
• Tracy Leticia Petrilli, PA-C

• Family Medicine Physician in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; 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.