Individual provider Active NPI

Sheila Marie Peterson, ARNP

  • Nurse Practitioner
  • Mount Airy, NC
National Provider Identifier
1457561987
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5004297 Issued in NC
Practice address
830 Rockford St
Mount Airy, NC 27030
Phone
(336) 719-7370
Fax
(336) 786-4048
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5004297 NC Primary

Addresses

Primary practice location

830 Rockford St
Mount Airy, NC 27030

Mailing address

PO Box 1267
Mount Airy, NC 27030-1267
Phone (336) 786-4522

Other practice location 1

601 John St
Box 74
Kalamazoo, MI 49007-5341
Phone (269) 341-8481

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090414000320 NC Practitioner - Nurse Practitioner 6709974157 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Hospital of Surry CountyGroup PAC ID 0244281749, 41 clinicians

Practice addresses (Care Compare)

830 Rockford St
Mount Airy, NC 27030-5322
Phone (336) 783-8374

Hospital & facility affiliations

  • Northern Regional Hospital Hospital, Mount Airy, NC, CCN 340003
  • Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5004297NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Hospital of Surry County Current Accepting new patients
Apogee Medical Group North Carolina CurrentSince May 13, 2011 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Jan 1, 2015 Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Northern Hospital of Surry County CurrentSince Jul 1, 2019 Accepting new patients
Forsyth Memorial Hospital Inc CurrentSince Jan 1, 2015 Accepting new patients
Northern Hospital of Surry County CurrentSince Jul 1, 2019 Accepting new patients
Northern Hospital of Surry County Past Accepting new patients

Locations

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

100 Johnson Ridge Medical Park
Elkin, NC 28621
Phone (336) 245-2100

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

708 S South St
#300
Mount Airy, NC 27030
Phone (336) 783-8030

423 S South St
Mount Airy, NC 27030
Phone (336) 786-5144

694 Riverside Dr
Mount Airy, NC 27030
Phone (336) 719-7892

830 Rockford St
Mount Airy, NC 27030
Phone (336) 719-7000

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

Organizations & group practices 8

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1457561987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1267",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270301267",
            "telephone_number": "336-786-4522",
            "fax_number": "336-786-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 ROCKFORD ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "27030",
            "telephone_number": "336-719-7370",
            "fax_number": "336-786-4048"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 John St",
            "address_2": "Box 74",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490075341",
            "country_code": "US",
            "telephone_number": "269-341-8481",
            "fax_number": "269-341-7781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SHEILA",
        "middle_name": "MARIE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5004297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Airy, NC

Sources for this page

Verify at the official NPI Registry.