Ebony Shandreka Peterson, FNP-BC, PMHNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

821513 Issued in NV

Practice address

2575 S Cimarron Rd Ste 104
Las Vegas, NV 89117-2682

Phone

(725) 712-4625

Fax

(725) 262-5536

NPI assigned

Sep 13, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hillcarehealthllc.ebonypeterson@162110.advancedmd-direct.com

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.

• Hill Care LLC

  dba Hill Care Health

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1871291872
  Medicare reassignment NPD Authorized official
• Deepa Hasija MD

  dba Satori Behavioral Health

  • Child & Adolescent Psychiatry Physician
  • Las Vegas, NV
  • NPI 1841721917
  Medicare reassignment NPD

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1396293841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 S CIMARRON RD STE 104",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891172682",
            "telephone_number": "725-712-4625",
            "fax_number": "725-262-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 S CIMARRON RD STE 104",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891172682",
            "telephone_number": "725-712-4625",
            "fax_number": "725-262-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "EBONY",
        "middle_name": "SHANDREKA",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-13",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "821513",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "821513",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "821513",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cedrick John Peterson
• Christine A Peterson, MD
• Colleen Margaret Peterson, PH.D.
• David John Peterson, D.O., PHARM. D.
• Doris Ann Peterson
• Elisabeth Peterson, LMSW
• Eric Taylor Peterson, DO
• Fidel Peterson
• Gabrielle Peterson, DO
• Gabrielle Irene Peterson, APRN

• Family Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.