Individual provider Active NPI

Rebecca E Peters, NP

  • Acute Care Nurse Practitioner
  • Baton Rouge, LA
National Provider Identifier
1497990659
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
213659 Issued in LA
Practice address
8300 Constantin Blvd
Baton Rouge, LA 70809-3489
Phone
(225) 765-8853
Fax
(225) 765-1700
NPI assigned
Dec 2, 2008
Last updated
Jun 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 213659 LA Primary
Pediatric Nurse Practitioner 363LP0200X 762682 TX

Addresses

Primary practice location

8300 Constantin Blvd
Baton Rouge, LA 70809-3489

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 526-0011

Other practice location 1

18200 Katy Fwy
MC Wa240
Houston, TX 77094-1285
Phone (832) 227-1300

Other identifiers 2

IdentifierTypeStateIssuer
8Y9463OtherTXBCBSTX
199630801MedicaidTX

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rpeters1279685@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20200629002332 LA Practitioner - Nurse Practitioner 4587720578 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
213659LAMDAcute Care Nurse Practitioner
762682TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC Nurse Practitioner Current Accepting new patients
Our Lady of the Lake Physician Group LLC CurrentSince Jun 22, 2020 Accepting new patients
Our Lady of the Lake Physician Group, LLC CurrentSince Jun 22, 2020 Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

8300 Constantin Blvd
Baton Rouge, LA 70809
Phone (225) 374-1410

Interoperability endpoints

  • Direct secure messaging: rpeters1279685@direct.casso.us.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1497990659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-526-0011",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 CONSTANTIN BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093489",
            "telephone_number": "225-765-8853",
            "fax_number": "225-765-1700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18200 Katy Fwy",
            "address_2": "MC WA240",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770941285",
            "country_code": "US",
            "telephone_number": "832-227-1300",
            "fax_number": "832-227-1340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "REBECCA",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-02",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "LA",
            "license": "213659",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "762682",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8Y9463",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199630801",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rpeters1279685@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "rpeters1279685@direct.casso.us.com",
            "address_1": "8300 Constantin Blvd",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708093489",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "8300 Constantin Blvd",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708093489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.