Hoang Kim Petersen, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP-10342 Issued in CO

Practice address

16728 E Smoky Hill Rd Unit 10D
Centennial, CO 80015-2400

Phone

(303) 766-7006

Fax

(303) 766-1023

NPI assigned

Jan 26, 2011

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 identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1780989590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 N THUNDERBIRD CIR STE 303",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852151219",
            "telephone_number": "480-455-4932",
            "fax_number": "480-776-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16728 E SMOKY HILL RD UNIT 10D",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800152400",
            "telephone_number": "303-766-7006",
            "fax_number": "303-766-1023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 S Coulter St",
            "address_purpose": "LOCATION",
            "city": "Amarillo",
            "state": "TX",
            "postal_code": "791061786",
            "country_code": "US",
            "telephone_number": "803-545-5630",
            "fax_number": "806-354-5689",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 S Coulter St",
            "address_purpose": "LOCATION",
            "city": "Amarillo",
            "state": "TX",
            "postal_code": "791061786",
            "country_code": "US",
            "telephone_number": "803-545-5630",
            "fax_number": "806-354-5689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "HOANG",
        "middle_name": "KIM",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1649",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "NP-10342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283185101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283185102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78459834",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283185104",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200342180 A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283185103",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael John Pesta, D.C.
• Joshua Timothy Peter, DDS
• Jacqueline Delia Peters, OTR, OTD
• Jamie Peters, PHARMD
• Melissa Peters, D.O.
• Kirk David Peterson, D.C.
• Kristen M Peterson, RN
• Krysta Brown Peterson, RN
• Richard Eric Peterson Jr., MD
• Sarah Michelle Peterson, RBT, BCBA

• Family Nurse Practitioner in Centennial, CO
• Providers in Centennial, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.