NPIMap

Individual provider Active NPI

Kari Josephine Peterson, M.D.

  • Emergency Medicine Physician
  • Meridian, ID
National Provider Identifier
1346363694
Registry record updated Sep 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
M-11248 Issued in ID
Practice address
2963 E Copper Point Dr
Suite 150
Meridian, ID 83642-9055
Phone
(208) 322-1730
Fax
(208) 322-1731
NPI assigned
Apr 9, 2007
Last updated
Sep 8, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD183336 OR
Emergency Medicine Physician 207P00000X MD2009-0568 NM
Emergency Medicine Physician 207P00000X M-11248 ID Primary

Addresses

Primary practice location

2963 E Copper Point Dr
Suite 150
Meridian, ID 83642-9055

Mailing address

2963 E Copper Point Dr
Suite 150
Meridian, ID 83642-9055
Phone (208) 322-8515

Other names 1

  • Mrs. Kari Josephine Davisson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110805000163 ID Practitioner - Emergency Medicine 5890811707 Reassigns benefits to 1 organization
I20170921002229 OR Practitioner - Emergency Medicine 5890811707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Washington School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America, LLC Emergency Medicine CurrentSince Aug 1, 2016 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Aug 1, 2016 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Oct 3, 2017 Accepting new patients
Cep America, LLC Emergency Medicine Current Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

2700 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 673-0611

Interoperability endpoints

  • Direct secure messaging: kpeterson1563888@direct.trinity-health.org

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504828800000",
    "number": "1346363694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2963 E COPPER POINT DR",
            "address_2": "SUITE 150",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429055",
            "telephone_number": "208-322-8515",
            "fax_number": "208-322-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2963 E COPPER POINT DR",
            "address_2": "SUITE 150",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429055",
            "telephone_number": "208-322-1730",
            "fax_number": "208-322-1731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KARI",
        "middle_name": "JOSEPHINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2017-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD183336",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "MD2009-0568",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "M-11248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARI",
            "last_name": "DAVISSON",
            "middle_name": "JOSEPHINE",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.