Active NPI
Mary Peterson
- Case Manager/Care Coordinator
- West Liberty, OH
National Provider Identifier
1770487753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 1521 N Detroit St
West Liberty, OH 43357-9805 - Phone
- (330) 673-1347
- Fax
- (326) 529-4070
- NPI assigned
- Oct 5, 2026
- Last updated
- Oct 5, 2026
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | NU | Primary |
Addresses
Primary practice location
1521 N Detroit St
West Liberty, OH 43357-9805
Mailing address
5982 Rhodes Rd
Kent, OH 44240-8100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1791158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1791158400000",
"number": "1770487753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5982 RHODES RD",
"city": "KENT",
"state": "OH",
"postal_code": "442408100",
"fax_number": "330-678-3677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1521 N DETROIT ST",
"city": "WEST LIBERTY",
"state": "OH",
"postal_code": "433579805",
"telephone_number": "330-673-1347",
"fax_number": "326-529-4070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2026-10-05",
"last_updated": "2026-10-05",
"certification_date": "2026-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Liberty, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.