Active NPI
Karen Peters, RDH
- Dental Hygienist
- Fort Richardson, AK
National Provider Identifier
1679922496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 413
- Practice address
- 600 Richardson Dr
BLD. # 634
Fort Richardson, AK 99505-8310 - Phone
- (907) 384-2483
- NPI assigned
- Jun 13, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 413 | AK | Primary |
| Dental Hygienist | 124Q00000X | 458 | AK |
Addresses
Primary practice location
600 Richardson Dr
BLD. # 634
Fort Richardson, AK 99505-8310
Mailing address
600 Richardson Dr
BLD. # 634
Fort Richardson, AK 99505-8310
Phone (907) 384-2483
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 458 | Other | AK | STATE OF AK LOCAL ANESTHETIC LICENSE |
| 413 | Other | AK | STATE OF AK DENTAL HYGIENE LICENSE |
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 |
|---|---|---|---|
| 413 | AK | MD | Chiropractor |
| 458 | AK | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465776000000",
"number": "1679922496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 RICHARDSON DR",
"address_2": "BLD. # 634",
"city": "FORT RICHARDSON",
"state": "AK",
"postal_code": "995058310",
"telephone_number": "907-384-2483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 RICHARDSON DR",
"address_2": "BLD. # 634",
"city": "FORT RICHARDSON",
"state": "AK",
"postal_code": "995058310",
"telephone_number": "907-384-2483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS",
"first_name": "KAREN",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-13",
"last_updated": "2016-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "AK",
"license": "413",
"primary": true
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "AK",
"license": "458",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF AK LOCAL ANESTHETIC LICENSE",
"identifier": "458",
"state": "AK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF AK DENTAL HYGIENE LICENSE",
"identifier": "413",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Richardson, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.