Sam Richard Petersen, CRNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

1-109909 Issued in AL

Practice address

201 Sivley Rd SW Ste 500
Huntsville, AL 35801-5177

Phone

(256) 265-3881

NPI assigned

Apr 10, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cullman Regional Medical Group Hospitalists LLCGroup PAC ID 5395176481, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cullman Regional Medical Center Hospital, Cullman, AL, CCN 010035
• Decatur Morgan Hospital - Decatur Campus Hospital, Decatur, AL, CCN 010085

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cullman Regional Medical Group Hospitalists LLC

  • Hospitalist Physician
  • Cullman, AL
  • NPI 1023642568
  Medicare reassignment Care Compare group NPD

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

• Cullman Regional Medical Center, Inc

  • General Acute Care Hospital
  • Cullman, AL
  • NPI 1114919339
  Care Compare affiliation
• H H Health System-Morgan LLC

  • General Acute Care Hospital
  • Decatur, AL
  • NPI 1356692297
  Care Compare affiliation

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767139200000",
    "number": "1386900728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SIVLEY RD SW STE 500",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015177",
            "telephone_number": "256-265-3881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SIVLEY RD SW STE 500",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015177",
            "telephone_number": "256-265-3881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1912 AL Highway 157",
            "address_purpose": "LOCATION",
            "city": "Cullman",
            "state": "AL",
            "postal_code": "350580609",
            "country_code": "US",
            "telephone_number": "256-737-2000",
            "fax_number": "256-737-2152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "SAM",
        "middle_name": "RICHARD",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-10",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-109909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tarek Omar Persaud, M.D.
• Persevere Behavioral Health LLC
• Peter Ditoro MD PC
• Amanda Peters, MS, ALC
• Rachel Rockman Petersen, M.D.
• Amy E Peterson-Wingo
• Monique Lolita Peterson, LICSW
• Kerriann Pettaway, DNP
• Christy Lynn Pettes, M.D.
• Gracie Deonne Pettus

• Acute Care Nurse Practitioner in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Acute Care Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.