Michelle Renae Peterson, DNP, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

112170 Issued in NE

Practice address

5425 W 132ND Ter
Leawood, KS 66209-3440

Phone

(402) 968-6829

NPI assigned

Feb 22, 2017

Sex

Female

Sole proprietor

No

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 IA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Alegent Creighton Clinic

  • Family Medicine Physician
  • Council Bluffs, IA
  • NPI 1598811069
  Medicare reassignment NPD
• Carespot Professional Services LLC

  • Urgent Care Clinic/Center
  • Overland Park, KS
  • NPI 1568703783
  NPD (past)
• Charles Drew Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Omaha, NE
  • NPI 1386218212
  NPD (past)

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

{
    "created_epoch": "1487721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1700325883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2529 MADISON ST",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680055366",
            "telephone_number": "402-968-6829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 W 132ND TER",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662093440",
            "telephone_number": "402-968-6829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MICHELLE",
        "middle_name": "RENAE",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-22",
        "last_updated": "2022-06-08",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "112170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Periodontal Specialist PA
• Cory Perry
• Megan Perry
• Troy C Peters
• Julie Peterson, APRN
• Shelly Lynne Peterson, PHD
• Traci Peterson
• Mark T Pfefer, D.C.
• Philip J Gordon DDS PA
• Evan Alan Phillips, O.D.

• Family Nurse Practitioner in Leawood, KS
• Providers in Leawood, KS by specialty
• Family Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.