Organization Active NPI

Kristi K Peterson MD PC

  • Obstetrics Physician
  • Papillion, NE
National Provider Identifier
1770627861
Registry record updated Jun 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
Legal business name
KRISTI K PETERSON MD PC
Practice address
10701 S 72ND St
Suite 100
Papillion, NE 68046-3427
Phone
(402) 827-9400
Fax
(402) 827-9405
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2008

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

Authorized official

Name
Dr. Kristi K Peterson, MDNPI 1427003136
Title
Owner
Phone
(402) 827-9400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VX0000X Primary

Addresses

Primary practice location

10701 S 72ND St
Suite 100
Papillion, NE 68046-3427

Mailing address

10701 S 72ND St
Suite 100
Papillion, NE 68046-3427
Phone (402) 827-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040326000588 NE Part B Supplier - Clinic/Group Practice 9537051321 Receives reassigned benefits from 1 practitioner
Practice locations: Papillion, NE

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
28D0875213Kristi K Peterson MD PC10701 South 72ND Street Suite 100, Papillion, NE 68046Provider-performed microscopyAug 18, 2027

National Provider Directory

National Provider Directory

Locations

10701 S 72nd St
Papillion, NE 68046
Phone (402) 827-9421

10701 S 72nd St
Ste 100
Papillion, NE 68046
Phone (402) 827-9400

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213488000000",
    "number": "1770627861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10701 S 72ND ST",
            "address_2": "SUITE 100",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680463427",
            "telephone_number": "402-827-9400",
            "fax_number": "402-827-9405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 S 72ND ST",
            "address_2": "SUITE 100",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680463427",
            "telephone_number": "402-827-9400",
            "fax_number": "402-827-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTI K PETERSON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2008-06-15",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-827-9400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Papillion, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.