Active NPI
Jamie Rachel Peterson, NP
- Nurse Practitioner
- Charlotte, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5007714
- Practice address
- 1001 Blythe Blvd
Medical Center Plaza Suite 200
Charlotte, NC 28203-5866 - Phone
- (704) 381-8840
- NPI assigned
- May 12, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5007714 | NC | Primary |
Addresses
Primary practice location
1001 Blythe Blvd
Medical Center Plaza Suite 200
Charlotte, NC 28203-5866
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Other practice location 1
920 Church St N
Concord, NC 28025-2927
Phone (704) 403-3664
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jmochel136913@CarolinasHealthcareSystem.direct-ci.com | Atrium Health | |
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | ABILITY Network |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolinas Physicians Network Inc. | Current | Accepting new patients | |
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| Carolinas Medical Center | Current | Accepting new patients | |
| Carolinas Medical Center | Current | Accepting new patients | |
| Carolinas Medical Center | Current | Accepting new patients | |
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| Carolinas Physicians Network, Inc | Past | Accepting new patients |
Locations
100 N 6th St
Ste 900A
Minneapolis, MN 55403
1001 Blythe Blvd
Ste 200
Charlotte, NC 28203
Phone (704) 373-0544
1001 Blythe Blvd
Ste 200D
Charlotte, NC 28203
Phone (704) 373-1813
1001 Blythe Blvd
Ste 601
Charlotte, NC 28203
Phone (704) 355-6930
1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791
920 Church St N
Concord, NC 28025
Phone (704) 403-3000
9625 Northcross Center Ct
Ste 102
Huntersville, NC 28078
Phone (704) 403-2860
134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100
Interoperability endpoints
- jmochel136913@carolinashealthcaresystem.direct-ci.com
Organizations & group practices 7
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.
-
- Obstetrics & Gynecology Physician
- Charlotte, NC
- NPI 1275774333
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Charlotte, NC
- NPI 1477878890
-
- Surgical Critical Care Physician
- Charlotte, NC
- NPI 1699979732
-
- Community/Retail Pharmacy
- Charlotte, NC
- NPI 1982710554
-
- Endocrinology, Diabetes & Metabolism Physician
- Charlotte, NC
- NPI 1437038544
-
- Vascular Surgery Physician
- Charlotte, NC
- NPI 1881624807
-
- Family Medicine Physician
- Charlotte, NC
- NPI 1578939914
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721001600000",
"number": "1447638366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19305",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282199305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 BLYTHE BLVD",
"address_2": "MEDICAL CENTER PLAZA SUITE 200",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035866",
"telephone_number": "704-381-8840"
}
],
"practiceLocations": [
{
"address_1": "920 Church St N",
"address_purpose": "LOCATION",
"city": "Concord",
"state": "NC",
"postal_code": "280252927",
"country_code": "US",
"telephone_number": "704-403-3664",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETERSON",
"first_name": "JAMIE",
"middle_name": "RACHEL",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-12",
"last_updated": "2024-07-15",
"certification_date": "2022-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "5007714",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jmochel136913@CarolinasHealthcareSystem.direct-ci.com",
"affiliation": "Y",
"affiliationName": "Atrium Health",
"address_1": "1001 Blythe Blvd",
"address_2": "Medical Center Plaza, Suite 200",
"city": "Charlotte",
"state": "NC",
"country_code": "US",
"postal_code": "282035866",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "ABILITY Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "100 N 6th St Ste 900A",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554031516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.