Active NPI
Tymerra Peterson
- Home Health Aide
- Hoover, AL
National Provider Identifier
1659921534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 2019-00044952
- Practice address
- 1 Chase Corporate Dr
Hoover, AL 35244-1026 - Phone
- (205) 747-5014
- NPI assigned
- Sep 12, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 2019-00044952 | AL | Primary |
Addresses
Primary practice location
1 Chase Corporate Dr
Hoover, AL 35244-1026
Mailing address
309 18TH Ave NW
Center Point, AL 35215-5225
Phone (205) 538-5559
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019-00044952 | AL | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568246400000",
"number": "1659921534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 18TH AVE NW",
"city": "CENTER POINT",
"state": "AL",
"postal_code": "352155225",
"telephone_number": "205-538-5559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CHASE CORPORATE DR",
"city": "HOOVER",
"state": "AL",
"postal_code": "352441026",
"telephone_number": "205-747-5014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "TYMERRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-12",
"last_updated": "2019-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Home Health Aide",
"state": "AL",
"license": "2019-00044952",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hoover, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.