Jessica Ann Peterson, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

50280 Issued in WY

Practice address

940 E 3Rd St Ste 205
Casper, WY 82601-3251

Phone

(307) 577-4260

NPI assigned

Jul 6, 2022

Last updated

Jul 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Ann Watson Former name

Medicare fee-for-service enrollment

Enrolled in WY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Casper Children's Center, LLC

  • Pediatrics Physician
  • Casper, WY
  • NPI 1114333127
  Medicare reassignment NPD
• 307 Pediatrics LLC

  • Pediatrics Physician
  • Casper, WY
  • NPI 1265288526
  NPD Authorized official
• Wyocity Medical Group LLC

  • Primary Care Clinic/Center
  • Casper, WY
  • NPI 1033800321
  NPD

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1881327971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 GARDEN CREEK RD",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826016638",
            "telephone_number": "307-851-3606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 E 3RD ST STE 205",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826013251",
            "telephone_number": "307-577-4260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "CPNP-PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-06",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WY",
            "license": "50280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "WATSON",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jacqueline Ann Peters, M.D.
• Paul Leon Peters, MD
• Roberta A Peters, RN
• Mary Petersen
• Jacob Dean Peterson, DDS
• Robert Lee Peterson, PSY.D.
• Archie Maurice Pettry III, M.S.
• Ashleigh Carolyn Petty
• Pharmaceutical Compounding Specialists of Wyoming
• Pharmacy Solutions Inc

• Pediatric Nurse Practitioner in Casper, WY
• Providers in Casper, WY by specialty
• Pediatric Nurse Practitioner in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.