Individual provider Active NPI

Jodi Lynn Peterson

  • Physician Assistant
  • Billings, MT
National Provider Identifier
1831575745
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
43199 Issued in MT
Practice address
1101 N 27TH St
Ste 101
Billings, MT 59101-0100
Phone
(406) 237-8282
NPI assigned
Aug 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 43199 MT Primary

Addresses

Primary practice location

1101 N 27TH St
Ste 101
Billings, MT 59101-0100

Mailing address

1101 N 27TH St
Ste 101
Billings, MT 59101-0100

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20151113002129 MT Practitioner - Physician Assistant 6608186044 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SCL Health Medical Group - Billings LLCGroup PAC ID 9638491574, 291 clinicians

Practice addresses (Care Compare)

1233 N 30TH St
Billings, MT 59101-0127
Phone (406) 237-3913

16 N Miles Ave
Suite 101
Hardin, MT 59034-2356
Phone (406) 237-8270

2223 Mission Way
Billings, MT 59102-0160
Phone (406) 237-8282

Hospital & facility affiliations

  • Intermountain Health St Vincent Regional Hospital Hospital, Billings, MT, CCN 270049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
43199MTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
SCL Health Montana CurrentSince Oct 12, 2020 Accepting new patients
SCL Health Medical Group - Billings, LLC CurrentSince Apr 1, 2016 Accepting new patients
SCL Health Montana CurrentSince Oct 12, 2020 Accepting new patients
SCL Health Medical Group - Billings LLC Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
St. Vincent Healthcare Past Accepting new patients

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

1101 N 27th St
Ste 101
Billings, MT 59101
Phone (406) 237-3660

1233 N 30th St
#3
Billings, MT 59101
Phone (406) 237-3850

1233 N 30th St
Billings, MT 59101
Phone (406) 237-3850

16 N Miles Ave
Hardin, MT 59034
Phone (406) 665-2205

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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": "1438560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1831575745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N 27TH ST",
            "address_2": "STE 101",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591010100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N 27TH ST",
            "address_2": "STE 101",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591010100",
            "telephone_number": "406-237-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JODI",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-03",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "43199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

Verify at the official NPI Registry.