Kelly Lee Peters, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F09180309 Issued in TX

Practice address

4311 Wesley St
Greenville, TX 75401-5639

Phone

(903) 455-5958

NPI assigned

Sep 11, 2018

Last updated

Mar 13, 2020By the provider in NPPES

Sex

Female

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 TX

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hunt Regional Urgent CareGroup PAC ID 1850729682, 31 clinicians

Community Health Service Agency, Inc.Group PAC ID 6305735150, shared by 7 NPIs, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hunt Regional Medical Center Hospital, Greenville, TX, CCN 450352

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hunt Regional Urgent Care

  • Urgent Care Clinic/Center
  • Greenville, TX
  • NPI 1033617931
  Medicare reassignment Care Compare group NPD

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

• Hunt Memorial Hospital District

  dba Hunt Regional

  • General Acute Care Hospital
  • Greenville, TX
  • NPI 1598750721
  Care Compare affiliation

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1417430935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 WESLEY ST",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754015639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4311 WESLEY ST",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754015639",
            "telephone_number": "903-455-5958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4910 County Road 2216",
            "address_purpose": "LOCATION",
            "city": "Caddo Mills",
            "state": "TX",
            "postal_code": "751358228",
            "country_code": "US",
            "telephone_number": "214-236-6338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "KELLY",
        "middle_name": "LEE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "F09180309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peppermint Dental - Greenville PLLC (Greenville Dental & Orthodontics)
• Joseph Millard Perks, DO
• Ronald James Peron, MD
• Charles William Perry III, LCSW
• Peter F Gray MD PA
• Mandolyn Mae Peterson
• David G Phelps, D.D.S.
• Mohan P Philip, M.D
• Rachel Philip, DO
• Camille Crawford Phillips, DPT

• Family Nurse Practitioner in Greenville, TX
• Providers in Greenville, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; 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.