Individual provider Active NPI

Janet Peters, NP

  • Nurse Practitioner
  • Saint Joseph, MI
National Provider Identifier
1396448726
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704380123 Issued in MI
Practice address
3903 Hollywood Rd
Saint Joseph, MI 49085-9149
Phone
(269) 408-1100
NPI assigned
Mar 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 28165725A IN
Nurse Practitioner 363L00000X 4704380123 MI Primary

Addresses

Primary practice location

3903 Hollywood Rd
Saint Joseph, MI 49085-9149

Mailing address

3903 Hollywood Rd
Saint Joseph, MI 49085-9149

Other practice location 1

632 S 13th St
Decatur, IN 46733-1859
Phone (260) 706-2013

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230330001201 IN Practitioner - Nurse Practitioner 7214301498
I20240215001692 MI Practitioner - Nurse Practitioner 7214301498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

3900 Hollywood Rd
Saint Joseph, MI 49085-9149
Phone (269) 983-3368

3903 Hollywood Rd
Saint Joseph, MI 49085-9149
Phone (269) 408-1100

3950 Hollywood Rd
Saint Joseph, MI 49085-9151

9623 Red Arrow Hwy
Bridgman, MI 49106-9559
Phone (269) 465-6050

9625 Red Arrow Hwy
Bridgman, MI 49106-9559
Phone (269) 465-6050

Hospital & facility affiliations

  • Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021
  • Corewell Health Watervliet Hospital Hospital, Watervliet, MI, CCN 230078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices CurrentSince Jan 23, 2024 Accepting new patients
Lakeland Medical Practices CurrentSince Jan 23, 2024 Accepting new patients

Locations

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

3903 Hollywood Rd
Saint Joseph, MI 49085
Phone (269) 408-1100

Interoperability endpoints

  • Direct secure messaging: jpeters1942678@epic00.corewelldirect.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1679616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1396448726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 HOLLYWOOD RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 HOLLYWOOD RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859149",
            "telephone_number": "269-408-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "632 S 13th St",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IN",
            "postal_code": "467331859",
            "country_code": "US",
            "telephone_number": "260-706-2013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "JANET",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-24",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "28165725A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704380123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.