Individual provider Active NPI

Jennifer M Peters, RN

  • Registered Nurse
  • Omaha, NE
National Provider Identifier
1689313744
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
61987 Issued in NE
Practice address
5321 S 138TH St
Omaha, NE 68137-2913
Phone
(402) 960-3193
NPI assigned
May 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 61987 NE Primary

Addresses

Primary practice location

5321 S 138TH St
Omaha, NE 68137-2913

Mailing address

5321 S 138TH St
Omaha, NE 68137-2913

Other practice location 1

2010 N 88th St
Omaha, NE 68134-6102
Phone (402) 960-3193

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.crccomaha.org Direct Connected Roots Care Center

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
61987NEMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1653609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1689313744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5321 S 138TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681372913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5321 S 138TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681372913",
            "telephone_number": "402-960-3193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2010 N 88th St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681346102",
            "country_code": "US",
            "telephone_number": "402-960-3193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-27",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "61987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.crccomaha.org",
            "affiliation": "Y",
            "affiliationName": "Connected Roots Care Center",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jpeters@crccomaha.org",
            "address_1": "5321 S 138TH ST",
            "city": "Omaha",
            "state": "NE",
            "country_code": "US",
            "postal_code": "681372913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; 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.