Desiree Elisabeth Peterson, CPNP-AC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

1056679 Issued in TX

Practice address

1401 W Pulaski St
Fort Worth, TX 76104-2717

Phone

(682) 885-8012

Fax

(682) 885-8014

NPI assigned

Nov 2, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Desiree Elisabeth Barnard-Peterson Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Interoperability endpoints

• Direct secure messaging: dbarardpeterson177297@cookchildrens.direct-ci.com
• Direct secure messaging: dbarnardpeterson177297@cookchildrens.direct-ci.com

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.

• Cook Children'S Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1750369203
  Medicare reassignment NPD
• Cook Children'S Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1083472062
  NPD

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1730844960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99213",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990213",
            "telephone_number": "682-885-4446",
            "fax_number": "817-810-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W PULASKI ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042717",
            "telephone_number": "682-885-8012",
            "fax_number": "682-885-8014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DESIREE",
        "middle_name": "ELISABETH",
        "credential": "CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-02",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1056679",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1056679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dbarardpeterson177297@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "1401 W Pulaski St",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761042717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DESIREE",
            "last_name": "BARNARD-PETERSON",
            "middle_name": "ELISABETH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Melissa Edwards Petersen, PHD
• Aaron Crispin Peterson, PA
• Beth M Peterson, LPA, LPC
• Betty Joyce Peterson, LCSW
• Crystal Peterson
• Fredda Peterson, OT
• Jennifer Elaine Peterson, PT
• Joel Peterson, LPC
• Lauren E Peterson, DDS
• Leah Peterson, OTR/L, OTD

• Acute Care Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Acute Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.