Paula M Peterson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

504482 Issued in TX

Practice address

2919 Markum Dr
Fort Worth, TX 76117-4004

Phone

(817) 831-0321

Fax

(817) 831-3211

NPI assigned

Aug 11, 2006

Last updated

Sep 16, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• T & R Clinic a Professional Association

  • Family Medicine Physician
  • Fort Worth, TX
  • NPI 1578514535
  Medicare reassignment NPD
• Texas Health Care, P.L.L.C.

  • Interventional Pain Medicine Physician
  • Fort Worth, TX
  • NPI 1477628873
  Medicare reassignment NPD
• Texas Health Care, P.L.L.C.

  • Otolaryngology Physician
  • Fort Worth, TX
  • NPI 1245686617
  NPD
• Texas Health Care, P.L.L.C.

  • Family Medicine Physician
  • Fort Worth, TX
  • NPI 1821026352
  NPD

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316131200000",
    "number": "1568473601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2919 MARKUM DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761174004",
            "telephone_number": "817-831-0321",
            "fax_number": "817-831-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 MARKUM DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761174004",
            "telephone_number": "817-831-0321",
            "fax_number": "817-831-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "PAULA",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2011-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "504482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID/TPI",
            "identifier": "092104102",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI NUMBER",
            "identifier": "1578514535",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP CLIA",
            "identifier": "45D0703080",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PIN",
            "identifier": "TXB110627",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "F057",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP EPSDT",
            "identifier": "092104103",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Elaine Peterson, PT
• Joel Peterson, LPC
• Lauren E Peterson, DDS
• Leah Peterson, OTR/L, OTD
• Megan Peterson, DC
• Jessica Paige Pethtel, LMSW
• Sondra C Petit, NP
• Aldis Michelle Petite
• Nicole Marie Petite, APRN
• Daniel Petr, PA-C

• Family Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.