Darrell L Peters

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

ARNP 9285722 Issued in FL

Practice address

3280 W Audubon Park Path
Lecanto, FL 34461-8450

Phone

(863) 712-6099

NPI assigned

Apr 8, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

State licenses

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1578982575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 W AUDUBON PARK PATH",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "344618450",
            "telephone_number": "863-712-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 W AUDUBON PARK PATH",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "344618450",
            "telephone_number": "863-712-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "DARRELL",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-08",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9285722",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP 9285722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric and Internal Medicine Specialists Inc
• Pediatric and Internal Medicine Specialists Inc
• Pediatric and Internal Medicine Specialists, PA
• Pedim Outreach and Specialty Clinic LLC
• Pedim Outreach and Specialty Clinic LLC
• Andrew J Petrella, MD
• Chris Pilon
• John E Popp, MD
• Austin Primis, D.O.
• Kenneth P Pritchyk, DPM

• Adult Health Nurse Practitioner in Lecanto, FL
• Providers in Lecanto, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.