NPIMap

Organization Active NPI

Blue Springs Family Care PC

  • Family Medicine Physician
  • Blue Springs, MO
National Provider Identifier
1811060767
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BLUE SPRINGS FAMILY CARE PC
Practice address
104 N. 7 Highway
Suite B
Blue Springs, MO 64014-7276
Phone
(816) 229-8880
Fax
(816) 229-4363
NPI assigned
Nov 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. John Eric Peterson, DONPI 1295728236
Title
President
Phone
(816) 229-8880

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

104 N. 7 Highway
Suite B
Blue Springs, MO 64014-7276

Mailing address

104 N. 7 Highway
Suite B
Blue Springs, MO 64014-2726
Phone (816) 229-8880

Other identifiers 2

IdentifierTypeStateIssuer
09239018OtherMOBCBS OF KC
1052OtherMOCOVENTRY GHP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040803000619 MO Part B Supplier - Clinic/Group Practice 8527039601 Receives reassigned benefits from 10 practitioners
Practice locations: Blue Springs, MO

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
26D0676092Blue Springs Family Care Center104 N 7 Hwy, Suite B, Blue Springs, MO 64014Provider-performed microscopyNov 16, 2026

National Provider Directory

National Provider Directory

Locations

104 NW State Route 7
Ste B
Blue Springs, MO 64014
Phone (816) 229-8880

Practitioners & affiliated clinicians

Practitioners 10

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": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811060767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 N. 7 HIGHWAY",
            "address_2": "SUITE B",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640142726",
            "telephone_number": "816-229-8880",
            "fax_number": "816-229-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 N. 7 HIGHWAY",
            "address_2": "SUITE B",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640147276",
            "telephone_number": "816-229-8880",
            "fax_number": "816-229-4363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SPRINGS FAMILY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-229-8880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KC",
            "identifier": "09239018",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY GHP",
            "identifier": "1052",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Springs, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.