Active NPI
Jennifer Kay Peterson, PHD, APRN-CNS, CCNS
- Pediatric Clinical Nurse Specialist
- Baltimore, MD
National Provider Identifier
1689882078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Clinical Nurse Specialist
- License
- CS00157
- Practice address
- 525 N Wolfe St
Baltimore, MD 21205-2110 - Phone
- (714) 280-3219
- NPI assigned
- May 18, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Clinical Nurse Specialist | 364SP0200X | CS00157 | MD | Primary |
Addresses
Primary practice location
525 N Wolfe St
Baltimore, MD 21205-2110
Mailing address
422 Crystal Downs CT
Owings Mills, MD 21117-4195
Phone (714) 280-3219
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CS00157 | MD | MD | Pediatric Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688601600000",
"number": "1689882078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "422 CRYSTAL DOWNS CT",
"city": "OWINGS MILLS",
"state": "MD",
"postal_code": "211174195",
"telephone_number": "714-280-3219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 N WOLFE ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212052110",
"telephone_number": "714-280-3219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "JENNIFER",
"middle_name": "KAY",
"name_prefix": "Dr.",
"credential": "PHD, APRN-CNS, CCNS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-18",
"last_updated": "2023-07-06",
"certification_date": "2023-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "364SP0200X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Pediatrics",
"state": "MD",
"license": "CS00157",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.