Kizzy Hargett Petersen, FNP, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5007734 Issued in NC

Practice address

2002 S Glenburnie Rd Ste 4C
New Bern, NC 28562-5230

Phone

(252) 675-4600

Fax

(252) 262-6306

NPI assigned

Jun 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kizzy Labrett Hargett Former name

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Carolina Behavioral Health and Wellness, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • New Bern, NC
  • NPI 1285236760
  Medicare reassignment NPD Authorized official
• Craven County

  • State or Local Public Health Clinic/Center
  • New Bern, NC
  • NPI 1295801827
  Medicare reassignment NPD
• Craven County

  • Community Based Hospice Care Agency
  • New Bern, NC
  • NPI 1154399434
  NPD
• Reflections Home Care, Inc.

  • Nursing Care Agency
  • New Bern, NC
  • NPI 1669707519
  NPD

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1457732414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14920",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285614920",
            "telephone_number": "252-675-4600",
            "fax_number": "252-262-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 S GLENBURNIE RD STE 4C",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625230",
            "telephone_number": "252-675-4600",
            "fax_number": "252-262-6306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "KIZZY",
        "middle_name": "HARGETT",
        "credential": "FNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5007734",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5007734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457732414",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIZZY",
            "last_name": "HARGETT",
            "middle_name": "LABRETT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James L. Perruquet, M.D.
• Shenequika Simone Perry, PT
• Teona Perry
• Peter P Greco MD
• Courtney Peters
• John A Peterson, PA C
• Vivian Marie Peterson, MD
• Alesia Petini
• Lorine Petty Staten
• Pharmacy Plus of New Bern, Inc

• Psychiatric/Mental Health Nurse Practitioner in New Bern, NC
• Providers in New Bern, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.

Verify at the official NPI Registry.