Lena Caroline Petersen, NP
Individual provider Active NPI Family Nurse Practitioner · Centerton, AR
NPI 1740700368 · NPPES record last updated Mar 6, 2025
Key facts
- NPI
- 1740700368
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 230416 (AR)
- Practice address
- 1225 E Centerton Blvd
Centerton, AR 72719-1225 - Phone
- (479) 795-1301
- Fax
- (479) 795-1304
- NPI assigned
- Jun 24, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 7
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Mercy Health Northwest Arkansas Communities
Practice addresses (Care Compare)
1225 E Centerton Blvd
Centerton, AR 72719-1225
Phone (479) 795-1301
Hospital & facility affiliations
- Mercy Hospital Northwest Arkansas
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.38 of 100
- Quality
- 63.01
- Promoting interoperability
- 98
- Improvement activities
- 40
- Cost
- 72.3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY, AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180404002072 | NY | Practitioner - Nurse Practitioner | 5991068934 | Reassigns benefits to 1 organization |
| I20250130000368 | AR | Practitioner - Nurse Practitioner | 5991068934 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 716670-1 | NY | MD | Registered Nurse |
| 230416 | AR | MD | Family Nurse Practitioner |
| 342629 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health Northwest Arkansas Communities | Current |
Accepting new patients | |
| Mercy Health Northwest Arkansas Communities | Multi-Specialty | Current |
Accepting new patients |
| Mercy Health Northwest Arkansas Communities | Multi-Specialty | Current | Accepting new patients |
| Hudson Valley Cardiovascular Practice, PC | Multi-Specialty | Current |
Accepting new patients |
Locations
3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100
1225 E Centerton Blvd
Centerton, AR 72719
Phone (479) 795-1301
150 Route 52
Carmel, NY 10512
Phone (845) 228-2910
1 Columbia St
Ste 300
Poughkeepsie, NY 12601
Phone (845) 483-0100
45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001
1 Columbia St
Ste 200
Poughkeepsie, NY 12601
Phone (845) 473-1188
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse |
163W00000X | 716670-1 | NY | |
| Family Nurse Practitioner | 363LF0000X | 342629 | NY | |
| Family Nurse Practitioner | 363LF0000X | 230416 | AR | Yes |
Addresses
Primary practice location
1225 E Centerton Blvd
Centerton, AR 72719-1225
Mailing address
PO Box 776084
Chicago, IL 60677-6084
Phone (314) 543-6979
Other practice location 1
30 E 33rd St Fl 5
New York, NY 10016-5337
Phone (406) 600-6999
Other providers in Centerton, AR
- Trystan Lee Oakley
- Molly G Ollie
- Ozark Family Chiropractic LLC
- Andrea Therese Paasch
- Pediatric Vision Development Center Inc.
- Petty and Petty, P. a.
- Megan Jo Petty
- Regan Skye Petty
- Phipps Family Dentistry
- Andrew Jason Phipps
All providers in Centerton, AR · Family Nurse Practitioner in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.