Individual provider Active NPI

Peng Zhou Anderson, FNP-C

  • Family Nurse Practitioner
  • New Orleans, LA
National Provider Identifier
1346777380
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP10194 Issued in LA
Practice address
5620 Read Blvd
New Orleans, LA 70127-3106
Phone
(504) 592-6600
NPI assigned
May 22, 2017
Last updated
Mar 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP133194 TX
Family Nurse Practitioner 363LF0000X AP10194 LA Primary

Addresses

Primary practice location

5620 Read Blvd
New Orleans, LA 70127-3106

Mailing address

1101 Medical Center Blvd
Marrero, LA 70072-3147
Phone (504) 349-1297

Other practice location 1

404 E San Marcos St
Pearsall, TX 78061-3226
Phone (830) 334-3336

Other practice location 2

205 N Commerce St
Dilley, TX 78017-3500
Phone (830) 965-4466

Other practice location 3

408 N Giraud
Cotulla, TX 78014-3113
Phone (830) 879-2279

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20180426001506 MS Practitioner - Nurse Practitioner 6608130778 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP133194TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grenada Physician Services, LLC CurrentSince Dec 17, 2019 Accepting new patients
University Physicians, PLLC Past Accepting new patients

Locations

960 Avent Dr
Grenada, MS 38901
Phone (662) 227-7000

Interoperability endpoints

  • Direct secure messaging: panderson148895@ummc.direct-ci.com

Organizations & group practices 2

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": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1346777380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MEDICAL CENTER BLVD",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723147",
            "telephone_number": "504-349-1297",
            "fax_number": "504-349-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 READ BLVD",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701273106",
            "telephone_number": "504-592-6600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "404 E San Marcos St",
            "address_purpose": "LOCATION",
            "city": "Pearsall",
            "state": "TX",
            "postal_code": "780613226",
            "country_code": "US",
            "telephone_number": "830-334-3336",
            "fax_number": "830-334-5574",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 N Commerce St",
            "address_purpose": "LOCATION",
            "city": "Dilley",
            "state": "TX",
            "postal_code": "780173500",
            "country_code": "US",
            "telephone_number": "830-965-4466",
            "fax_number": "830-965-4467",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "408 N Giraud",
            "address_purpose": "LOCATION",
            "city": "Cotulla",
            "state": "TX",
            "postal_code": "780143113",
            "country_code": "US",
            "telephone_number": "830-879-2279",
            "fax_number": "830-879-2235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "PENG",
        "middle_name": "ZHOU",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-22",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP133194",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP10194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.