Active NPI
Phylis Petersen
- Personal Care Attendant
- Saint Paul, NE
National Provider Identifier
1386440246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- Practice address
- 1310 Kendall St
Saint Paul, NE 68873-1422 - Phone
- (308) 750-6394
- NPI assigned
- Feb 21, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Primary |
Addresses
Primary practice location
1310 Kendall St
Saint Paul, NE 68873-1422
Mailing address
1310 Kendall St
Saint Paul, NE 68873-1422
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740096000000",
"number": "1386440246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1310 KENDALL ST",
"city": "SAINT PAUL",
"state": "NE",
"postal_code": "688731422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 KENDALL ST",
"city": "SAINT PAUL",
"state": "NE",
"postal_code": "688731422",
"telephone_number": "308-750-6394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "PHYLIS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-02-21",
"last_updated": "2025-02-21",
"certification_date": "2025-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.