Michelle Dawn Peterson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3016901 Issued in KY

Practice address

615 Washington St
Shelbyville, KY 40065-1131

Phone

(502) 647-4668

NPI assigned

Oct 27, 2021

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 KY, IN2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.72 of 100Reported as group

Quality

66.02

Promoting interoperability

100

Improvement activities

40

Cost

79.72

Merit-based Incentive Payment System (MIPS)

Final score

81.11 of 100Reported as group

Quality

63.34

Promoting interoperability

100

Improvement activities

40

Cost

73.68

Merit-based Incentive Payment System (MIPS)

Final score

83.89 of 100Reported as group

Quality

67.99

Promoting interoperability

100

Improvement activities

40

Cost

78.32

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michelle.peterson@krogerhealth.eclinicaldirectplus.com
• Direct secure messaging: mpeterson289412@direct.nortonhealthcare.org

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.

• Community Medical Associates, Inc.

  • Multi-Specialty Clinic/Center
  • Louisville, KY
  • NPI 1306983762

  Family

  Medicare reassignment Care Compare group NPD
• Kiosk Medicine Kentucky LLC

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1205885035
  Medicare reassignment NPD
• Little Clinic of in LLC

  • Family Nurse Practitioner
  • Floyds Knobs, IN
  • NPI 1558791384
  Medicare reassignment NPD
• Community Medical Associates, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1881192409
  NPD
• Operation Care Inc.

  • Primary Care Clinic/Center
  • Shelbyville, KY
  • NPI 1366052128
  NPD

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1871257741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 WASHINGTON ST",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400651131",
            "telephone_number": "502-647-4668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 WASHINGTON ST",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400651131",
            "telephone_number": "502-647-4668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MICHELLE",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3016901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Nicole Perlack, OT
• Amanda Lee Petersen, OTR
• Ashley Peterson
• Hannah Nicole Peterson
• Jessica Peterson, LSW
• Rachael Petrie
• Jenah Peyton
• Taylor Morgan Boulier Phelps
• Shelby Dawn Phillips-Brown
• Amy Phillips

• Family Nurse Practitioner in Shelbyville, KY
• Providers in Shelbyville, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.