Kerry G Peterson, ARNP, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP60443753 Issued in WA

Practice address

106 N 1St St
Elma, WA 98541

Phone

(360) 482-2851

Fax

(844) 315-8272

NPI assigned

Feb 10, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Summit Pacific Medical Center Hospital, Elma, WA, CCN 501304
• Grays Harbor Community Hospital Hospital, Aberdeen, WA, CCN 500031

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• KGP LLC

  dba Kerry Peterson FNP

  • Family Nurse Practitioner
  • Montesano, WA
  • NPI 1073939427
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Grays Harbor Community Hospital

  • General Acute Care Hospital
  • Aberdeen, WA
  • NPI 1154378859
  Care Compare affiliation
• Grays Harbor County Public Hospital District No 1

  dba Summit Pacific Medical Center

  • Critical Access Hospital
  • Elma, WA
  • NPI 1740211028
  Care Compare affiliation

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

{
    "created_epoch": "1391990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1790109825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 803",
            "city": "ELMA",
            "state": "WA",
            "postal_code": "98541",
            "telephone_number": "360-482-2851",
            "fax_number": "844-315-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 N 1ST ST",
            "city": "ELMA",
            "state": "WA",
            "postal_code": "98541",
            "telephone_number": "360-482-2851",
            "fax_number": "844-315-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KERRY",
        "middle_name": "G",
        "credential": "ARNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-10",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60443753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Medical Specialty Group
• Holly Hope Paul, ARNP
• Paulines Peaceful Pathways PLLC
• Kimberly Ann Peters, CDP
• Jordan Matthew Peterson, DC
• Matthew S. Peterson, D.C.
• Michelle Elizabeth Peterson
• Sarah Joy Pinkerton, ARNP
• Brock Dustin Pohl, CDP
• Ayan A Rage, M.D.

• Family Nurse Practitioner in Elma, WA
• Providers in Elma, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.
• 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.