Karl Robert Peterson, APRN CNM

Primary specialty

MidwifeTaxonomy code 176B00000X

License

2003021203 Issued in MO

Practice address

317 Golden Cherry Dr
Grover, MO 63040-1658

Phone

(636) 273-1298

NPI assigned

Jan 19, 2011

Last updated

Jan 19, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

Practice roles

Locations

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.

• Mercy Womens Services LLC

  • Obstetrics & Gynecology Physician
  • Saint Louis, MO
  • NPI 1629327788
  Medicare reassignment NPD

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

{
    "created_epoch": "1295395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295395200000",
    "number": "1700181922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 GOLDEN CHERRY DR",
            "city": "GROVER",
            "state": "MO",
            "postal_code": "630401658",
            "telephone_number": "636-273-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 GOLDEN CHERRY DR",
            "city": "GROVER",
            "state": "MO",
            "postal_code": "630401658",
            "telephone_number": "636-273-1298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KARL",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "APRN CNM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-19",
        "last_updated": "2011-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "MO",
            "license": "2003021203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond Joseph Marey, D. D. S.
• Lucas J Meyer, D.M.D.
• Marla M Olish, PNP
• Optimal Health Chiropractic LLC
• Elizabeth Pemberton, AGNP
• Professional Healthcare Services, LLC
• Stephanie Smith, D.C.
• Andrew Warner, M.ED, PLPC
• Judy M Wylie, LPC

• Midwife in Grover, MO
• Providers in Grover, MO by specialty
• Midwife in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.