Individual provider Active NPI

Nicolette Peters, CRNP

  • Nurse Practitioner
  • Opelika, AL
National Provider Identifier
1669925251
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-142693 Issued in AL
Practice address
2000 Pepperell Pkwy
Opelika, AL 36801-5452
Phone
(334) 528-1112
NPI assigned
Jul 29, 2016
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-142693 AL Primary

Addresses

Primary practice location

2000 Pepperell Pkwy
Opelika, AL 36801-5452

Mailing address

1722 Pine St
Suite 503
Montgomery, AL 36106-1103
Phone (334) 240-2337

Other practice location 1

1758 Park Pl Ste 300
Montgomery, AL 36106-1137
Phone (334) 293-8922

Other names 1

  • Nicolette Bohy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20161014001609 AL Practitioner - Nurse Practitioner 0345538864 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mills Physican Acute Care Services, LLCGroup PAC ID 2961866991, 13 clinicians

Practice addresses (Care Compare)

1850 Shug Jordan Pkwy
Suite 101
Auburn, AL 36830-3084
Phone (334) 209-1117

2000 Pepperell Pkwy
Opelika, AL 36801-5452
Phone (334) 749-3411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.26 of 100Reported as group
Quality
78.94
Promoting interoperability
100
Improvement activities
40
Cost
72.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-142693ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Hospital & Clinic, Inc. CurrentSince Aug 27, 2016 Accepting new patients
Jackson Hospital and Clinic, Inc. Nurse Practitioner Current Accepting new patients
The East Alabama Health Care Authority Current Accepting new patients
The East Alabama Health Care Authority CurrentSince Dec 1, 2016 Accepting new patients
Mills Physican Acute Care Services, LLC CurrentSince Aug 30, 2023 Accepting new patients
Jackson Hospital & Clinic, Inc. CurrentSince Aug 27, 2016 Accepting new patients
Eamc ER Physicians CurrentSince Dec 1, 2016 Accepting new patients

Locations

1850 Shug Jordan Pkwy
Ste 101
Auburn, AL 36830
Phone (334) 209-1117

764 E Glenn Ave
Auburn, AL 36830
Phone (334) 329-6268

1722 Pine St
Ste 503
Montgomery, AL 36106
Phone (334) 240-2337

1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000

1758 Park Pl
Ste 300
Montgomery, AL 36106
Phone (334) 274-1204

2000 Pepperell Pkwy
Opelika, AL 36801
Phone (334) 364-3300

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.181001
  • FHIR API: https://fhir-myrecord.cerner.com/r4/c5013bf3-ebba-4bda-8574-ed83da9e1633/

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1469750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1669925251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 PINE ST",
            "address_2": "SUITE 503",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061103",
            "telephone_number": "334-240-2337",
            "fax_number": "334-293-6859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 PEPPERELL PKWY",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368015452",
            "telephone_number": "334-528-1112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1758 Park Pl Ste 300",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "AL",
            "postal_code": "361061137",
            "country_code": "US",
            "telephone_number": "334-293-8922",
            "fax_number": "334-293-6820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "NICOLETTE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-142693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLETTE",
            "last_name": "BOHY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Opelika, AL

Sources for this page

Verify at the official NPI Registry.