Theresa A Petersen, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

111495 Issued in NE

Practice address

300 N 2ND St
Ste 100
Oneill, NE 68763-1519

Phone

(402) 336-2900

NPI assigned

Dec 9, 2013

Last updated

Dec 19, 2013By 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

Medicare fee-for-service enrollment

Enrolled in NE, SD2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avera St Anthonys HospitalGroup PAC ID 4486548203, shared by 5 NPIs, 23 clinicians

Wagner Community Memorial HospitalGroup PAC ID 3577459700, 17 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

74.55 of 100Reported as group

Quality

66.54

Promoting interoperability

100

Improvement activities

40

Cost

45.26

Merit-based Incentive Payment System (MIPS)

Final score

95.27 of 100Reported as apm

Quality

85.98

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: theresa.petersen@avera.sdhealthlink.net

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.

• Wagner Community Memorial Hospital

  • Family Medicine Physician
  • Wagner, SD
  • NPI 1740306992
  Medicare reassignment Care Compare group NPD
• Avera St Anthonys Hospital

  • Certified Registered Nurse Anesthetist
  • O'Neill, NE
  • NPI 1043223654
  Medicare reassignment NPD
• Avera St Anthonys Hospital

  dba Avera Medical Group Spencer

  • Rural Health Clinic/Center
  • Spencer, NE
  • NPI 1629344692
  NPD
• Avera St Anthonys Hospital

  dba Avera Medical Group O'Neill

  • Rural Health Clinic/Center
  • O'Neill, NE
  • NPI 1861787194

  Nurse Practitioner

  NPD
• Wagner Community Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Wagner, SD
  • NPI 1629135645
  NPD

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

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1649601287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270",
            "city": "ONEILL",
            "state": "NE",
            "postal_code": "687630270",
            "telephone_number": "402-336-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N 2ND ST",
            "address_2": "STE 100",
            "city": "ONEILL",
            "state": "NE",
            "postal_code": "687631519",
            "telephone_number": "402-336-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "THERESA",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-09",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "111495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audrea Lynn Parks
• Alana Sue Pearson, CTA
• Lisa Pearson
• Tessa W Pelster, OD
• Shawntelle D Peter
• Pamela Peterson
• Paula Peterson
• Jenny Lynn Pfeifer
• Dena Pirnie, PLMHP
• Kennah Pitts

• Nurse Practitioner in O'Neill, NE
• Providers in O'Neill, NE by specialty
• Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; 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.