Stephanie Alexis Peterson, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86172573 Issued in WI

Practice address

905 Verdae Blvd Ste 202
Greenville, SC 29607-4098

Phone

(864) 522-2100

NPI assigned

Nov 24, 2021

Last updated

Nov 24, 2021By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1637712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1669139655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 VERDAE BLVD STE 202",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296074098",
            "telephone_number": "864-522-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "STEPHANIE",
        "middle_name": "ALEXIS",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-24",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "SC",
            "license": "2155",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "86172573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valarie Anne Petersen, APRN, BC
• Catherine Michelle Peterson, PSY.D.
• Christopher Morrison Peterson, MD
• Hannah Peterson, PT, DPT
• Karren Peterson, M.A., M.S., LPC-I
• Megan Pethel
• Carol V Petillo, PHD
• Aziz Firoz Petiwala, ACNP
• Brianna Nicole Petratos
• Taylor Petree

• Registered Dietitian in Greenville, SC
• Providers in Greenville, SC by specialty
• Registered Dietitian in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; 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.