NPIMap

Individual provider Active NPI

Jessica Raeann Peters, NP

  • Family Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1821721523
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2022005937 Issued in MO
Practice address
2055 S Fremont Ave
Springfield, MO 65804-2206
Phone
(417) 820-8099
NPI assigned
Jul 8, 2022
Last updated
Aug 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2022005937 MO Primary

Addresses

Primary practice location

2055 S Fremont Ave
Springfield, MO 65804-2206

Mailing address

2055 S Fremont Ave
Springfield, MO 65804-2206
Phone (417) 820-8099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220816002681 MO Practitioner - Nurse Practitioner 6305229899 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

2055 S Fremont Ave
1000 MC Cancer and Hematology
Springfield, MO 65804-2206
Phone (417) 820-8099

448 State Hwy 248
Suite 190
Branson, MO 65616-3725
Phone (417) 334-7647

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2022005937MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Aug 21, 2022 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Aug 21, 2022 Accepting new patients
Mercy Clinic Springfield Communities Family CurrentSince Aug 21, 2022 Accepting new patients

Locations

448 State Highway 248
Ste 190
Branson, MO 65616
Phone (417) 334-7647

100 Hospital Dr
Lebanon, MO 65536
Phone (417) 533-6010

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

2055 S Fremont Ave
Springfield, MO 65804
Phone (417) 820-2468

2055 S Fremont Ave
#1000
Springfield, MO 65804
Phone (417) 820-8099

2055 S Fremont Ave
Fl 2
Springfield, MO 65804
Phone (417) 820-8099

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1821721523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 S FREMONT AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042206",
            "telephone_number": "417-820-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 S FREMONT AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042206",
            "telephone_number": "417-820-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "JESSICA",
        "middle_name": "RAEANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-08",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2022005937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.