Larnetta Renne Peterson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

4050 Central Ave
Saint Petersburg, FL 33711-1239

Phone

(727) 327-7656

Fax

(727) 322-2130

NPI assigned

Mar 20, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Suncoast Center Inc

  • Case Management Agency
  • St Petersburg, FL
  • NPI 1457021321
  NPD
• Suncoast Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Petersburg, FL
  • NPI 1659371763
  NPD (past)

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1548535867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10970",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337330970",
            "telephone_number": "727-327-7656",
            "fax_number": "727-322-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 CENTRAL AVE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337111239",
            "telephone_number": "727-327-7656",
            "fax_number": "727-322-2130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4024 Central Ave",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337111239",
            "country_code": "US",
            "telephone_number": "727-327-7656 x4221",
            "fax_number": "727-322-2130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4010 Central Ave",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337111239",
            "country_code": "US",
            "telephone_number": "727-327-7656 x4221",
            "fax_number": "727-322-2130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "LARNETTA",
        "middle_name": "RENNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-20",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060381300",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@suncoastcenter.org",
            "affiliation": "N",
            "address_1": "4024 Central Ave",
            "city": "St Petersburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337111239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carl Peterson, COTA
• Christopher Peterson
• Daniel Peterson
• Felipe Peterson, DPM
• John A. Peterson, MD
• Mitchell Robert Petit, O.D.
• Thomas E Petit, LMHC
• Lisa E Petitfils, M.D.
• Guy Timothy Petito, O.D.
• Renee Petrie

• Case Manager/Care Coordinator in Saint Petersburg, FL
• Providers in Saint Petersburg, FL by specialty
• Case Manager/Care Coordinator in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.