Individual provider Active NPI

Trina Ann Peterson, RN

  • Registered Nurse
  • Bainbridge Island, WA
National Provider Identifier
1346570371
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
00175604 Issued in WA
Practice address
2213 N.E. Victorian Lane
C
Bainbridge Island,, WA 98110
Phone
(206) 579-4365
NPI assigned
Jan 14, 2010
Last updated
Jan 14, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 00175604 WA Primary

Addresses

Primary practice location

2213 N.E. Victorian Lane
C
Bainbridge Island,, WA 98110

Mailing address

2213 N.E. Victorian Lane
C
Bainbridge Island,, WA 98110
Phone (206) 579-4365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
00175604WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1346570371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 N.E. VICTORIAN LANE",
            "address_2": "C",
            "city": "BAINBRIDGE ISLAND,",
            "state": "WA",
            "postal_code": "98110",
            "telephone_number": "206-579-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 N.E. VICTORIAN LANE",
            "address_2": "C",
            "city": "BAINBRIDGE ISLAND,",
            "state": "WA",
            "postal_code": "98110",
            "telephone_number": "206-579-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "TRINA",
        "middle_name": "ANN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-14",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "00175604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.