Alice Petersen, MSN, FNP-C, CCRA

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5018386 Issued in NC

Practice address

444 SW Center St
Faison, NC 28341-8820

Phone

(910) 267-0421

Fax

(910) 267-8989

NPI assigned

Oct 22, 2020

Last updated

Aug 3, 2023By the provider in NPPES

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 NC

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

Master of Science - Nursing

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: apetersen@goshenmedical.cloudcraftdirect.com

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.

• Goshen Medical Center, Incorporated

  dba Goshen Medical Center - Duplin

  • Federally Qualified Health Center (FQHC)
  • Kenansville, NC
  • NPI 1962124974
  Medicare reassignment NPD
• Goshen Medical Center Incorporated

  • Federally Qualified Health Center (FQHC)
  • Faison, NC
  • NPI 1154378933
  NPD
• Goshen Medical Center Incorporated

  dba GMC Pharmacy at Rockingham

  • Federally Qualified Health Center (FQHC)
  • Rockingham, NC
  • NPI 1457181323
  NPD
• Karen H. Harum, MD, Faap, PLLC

  dba dba Clinic for Special Children

  • Pediatric Neurodevelopmental Disabilities Physician
  • Wilmington, NC
  • NPI 1841410412
  NPD (past)

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1902405665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 187",
            "city": "FAISON",
            "state": "NC",
            "postal_code": "283410187",
            "telephone_number": "910-267-0421",
            "fax_number": "855-996-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 SW CENTER ST",
            "city": "FAISON",
            "state": "NC",
            "postal_code": "283418820",
            "telephone_number": "910-267-0421",
            "fax_number": "910-267-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "ALICE",
        "name_prefix": "Ms.",
        "credential": "MSN, FNP-C, CCRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-22",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5018386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Hobbs Langston
• Lea Taylor Meeks
• Perla Mendo Lopez
• John Ralph Page, M.D.
• Keith Patti, PHARM
• Julissa Quintanilla, PA-C
• Randall Richards, M.D.
• Renzo Santisteban, DMD
• Walter R Schmits Jr., M.D.
• Katheryn M Sican, PA-C

• Family Nurse Practitioner in Faison, NC
• Providers in Faison, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.