Individual provider Active NPI

Kami L Peterson, BSN, RN, FNP-C

  • Family Nurse Practitioner
  • Dickinson, ND
National Provider Identifier
1679955629
Registry record updated Apr 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R37563 Issued in ND
Practice address
2615 Fairway St
Dickinson, ND 58601-2590
Phone
(701) 456-6111
NPI assigned
Jun 26, 2015
Last updated
Apr 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R37563 ND Primary

Addresses

Primary practice location

2615 Fairway St
Dickinson, ND 58601-2590

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20150908001363 ND Practitioner - Nurse Practitioner 2668788563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford BismarckGroup PAC ID 9739098575, 562 clinicians
Omaha Therapy IncGroup PAC ID 1557270915, 68 clinicians

Practice addresses (Care Compare)

2615 Fairway St
Dickinson, ND 58601-2590
Phone (701) 456-6000

683 State Ave
Dickinson, ND 58601-4660
Phone (701) 483-9400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck CurrentSince Jul 22, 2015 Accepting new patients

Locations

3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300

2615 Fairway St
Dickinson, ND 58601
Phone (701) 456-6000

33 9th St W
Dickinson, ND 58601
Phone (701) 483-4858

Organizations & group practices 2

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 3

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": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745107200000",
    "number": "1679955629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 FAIRWAY ST",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586012590",
            "telephone_number": "701-456-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KAMI",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "BSN, RN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-26",
        "last_updated": "2025-04-20",
        "certification_date": "2025-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R37563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickinson, ND

Sources for this page

Verify at the official NPI Registry.