Rebecca S Peterson, CCHW

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

5601 Loch Raven Blvd # G4
Baltimore, MD 21239-2945

Phone

(410) 459-8779

NPI assigned

Sep 25, 2020

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1386251114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD # G4",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392945",
            "telephone_number": "410-459-8779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD # G4",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392945",
            "telephone_number": "410-459-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "REBECCA",
        "middle_name": "S",
        "credential": "CCHW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-25",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "09/30/2025",
            "affiliation": "N",
            "address_1": "5601 Loch Raven Blvd # G4",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212392945",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "09/30/2025",
            "affiliation": "N",
            "address_1": "5601 Loch Raven Blvd # G4",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212392945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kelvin John Peterson, MD
• Kimberly Peterson, APRN-CNS
• Kimberly B Peterson, PTA
• Natasha Peterson, LCPC
• Rachel Peterson
• Susan Marie Peterson
• Valerie Peterson, CRNP
• Geralynn Petit, C.R.N.P.
• James Petit, MD
• Lisa W Petit, MD

• Community Health Worker in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Community Health Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; 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.