Active NPI
Jessica Lee Peterson, FNP-C
- Family Nurse Practitioner
- Parker, CO
National Provider Identifier
1447713102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APN.0994416-NP
- Practice address
- 12230 Lioness Way
Parker, CO 80134-5603 - Phone
- (720) 644-9355
- NPI assigned
- Apr 10, 2019
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN.1626086 | CO | |
| Family Nurse Practitioner | 363LF0000X | RXN.0103823-NP | CO | |
| Family Nurse Practitioner | 363LF0000X | APN.0994416-NP | CO | Primary |
Addresses
Primary practice location
12230 Lioness Way
Parker, CO 80134-5603
Mailing address
12230 Lioness Way
Parker, CO 80134-5603
Phone (720) 644-9355
Other practice location 1
3210 N Academy Blvd Ste 3
Colorado Springs, CO 80917-5158
Phone (719) 531-0409 ext. 106
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190513000457 | CO | Practitioner - Nurse Practitioner | 1052654142 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
925 N Lincoln St
Apt 15a
Denver, CO 80203-2768
Phone (720) 500-5488
Hospital & facility affiliations
- Uch-Memorial Health System
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN.1626086 | CO | MD | Registered Nurse |
| RXN.0103823-NP | CO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Goodness Health, LLC | Current | Accepting new patients | |
| Goodness Health, LLC | Current | Accepting new patients |
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.
-
- Internal Medicine Physician
- Centerville, UT
- NPI 1407659998
Hospital & facility affiliations 18
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": "1554854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630281600000",
"number": "1447713102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12230 LIONESS WAY",
"city": "PARKER",
"state": "CO",
"postal_code": "801345603",
"telephone_number": "720-644-9355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12230 LIONESS WAY",
"city": "PARKER",
"state": "CO",
"postal_code": "801345603",
"telephone_number": "720-644-9355"
}
],
"practiceLocations": [
{
"address_1": "3210 N Academy Blvd Ste 3",
"address_purpose": "LOCATION",
"city": "Colorado Springs",
"state": "CO",
"postal_code": "809175158",
"country_code": "US",
"telephone_number": "719-531-0409 x106",
"fax_number": "719-531-0410",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETERSON",
"first_name": "JESSICA",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-10",
"last_updated": "2021-08-30",
"certification_date": "2021-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CO",
"license": "RN.1626086",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CO",
"license": "RXN.0103823-NP",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CO",
"license": "APN.0994416-NP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Parker, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; 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.