Individual provider Active NPI

Lori A Petersen, NP

  • Gerontology Nurse Practitioner
  • Nashua, NH
National Provider Identifier
1407906704
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN214795 Issued in MA
Practice address
8 Prospect St
Nashua, NH 03060-3925
Phone
(603) 577-2039
Fax
(603) 882-5656
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN214795 MA Primary
Nurse Practitioner 363L00000X 214795 MA
Nurse Practitioner 363L00000X 069512-23 NH

Addresses

Primary practice location

8 Prospect St
Nashua, NH 03060-3925

Mailing address

8 Prospect St
Nashua, NH 03060-3925
Phone (603) 577-2039

Other practice location 1

41 Mall Rd
Burlington, MA 01805-3925
Phone (781) 744-8085

Other identifiers 1

IdentifierTypeStateIssuer
110019301AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 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
I20071025000675 MA Practitioner - Nurse Practitioner 8325135148 Reassigns benefits to 2 organizations
I20140822001129 NH Practitioner - Nurse Practitioner 8325135148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foundation Medical Partners IncGroup PAC ID 9436140456, 313 clinicians
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

10 Jones Rd
Milford, NH 03055-3100
Phone (603) 672-7600

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

8 Prospect St
Nashua, NH 03060-3925
Phone (603) 577-2045

8 Prospect St N
Nashua, NH 03060-3925

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
214795MAMDNurse Practitioner
069512-23NHMDNurse Practitioner
RN214795MAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Foundation Medical Partners Inc. CurrentSince Aug 1, 2014 Accepting new patients
Foundation Medical Partners Inc CurrentSince Aug 1, 2014 Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

10 Jones Rd
Milford, NH 03055
Phone (603) 672-7600

8 Prospect St
#2
Nashua, NH 03060
Phone (603) 882-8375

8 Prospect St
Nashua, NH 03060
Phone (603) 281-9275

Organizations & group practices 4

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1407906704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 PROSPECT ST",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030603925",
            "telephone_number": "603-577-2039",
            "fax_number": "603-882-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 PROSPECT ST",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030603925",
            "telephone_number": "603-577-2039",
            "fax_number": "603-882-5656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018053925",
            "country_code": "US",
            "telephone_number": "781-744-8085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "LORI",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN214795",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "214795",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NH",
            "license": "069512-23",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110019301A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

Verify at the official NPI Registry.