Individual provider Active NPI

Rebecca J Peterson, A.R.N.P.

  • Nurse Practitioner
  • Olympia, WA
National Provider Identifier
1700958030
Registry record updated Dec 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP30005731 Issued in WA
Practice address
3525 Ensign Rd NE Ste J
Olympia, WA 98506-5065
Phone
(360) 491-0459
Fax
(360) 491-5370
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP30005731 WA Primary

Addresses

Primary practice location

3525 Ensign Rd NE Ste J
Olympia, WA 98506-5065

Mailing address

3525 Ensign Rd NE Ste J
Olympia, WA 98506-5065
Phone (360) 491-0459

Other identifiers 1

IdentifierTypeStateIssuer
9630625MedicaidWA

Other names 1

  • Becky J Peterson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20100812000276 WA Practitioner - Nurse Practitioner 3577697549

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP30005731WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Options Consulting, PLLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197590400000",
    "number": "1700958030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 ENSIGN RD NE STE J",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065065",
            "telephone_number": "360-491-0459",
            "fax_number": "360-491-5370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 ENSIGN RD NE STE J",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065065",
            "telephone_number": "360-491-0459",
            "fax_number": "360-491-5370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "REBECCA",
        "middle_name": "J",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30005731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9630625",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BECKY",
            "last_name": "PETERSON",
            "middle_name": "J",
            "credential": "ARNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.