Krystal Peterson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

311 Soybean Dr
Appomattox, VA 24522-4308

Phone

(434) 258-7818

Fax

(434) 664-2023

NPI assigned

Sep 19, 2015

Last updated

Sep 19, 2015By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• At Home Service Management, LLC

  • Case Management Agency
  • Appomattox, VA
  • NPI 1932635406
  NPD (past)

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

{
    "created_epoch": "1442620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442620800000",
    "number": "1922477918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 SOYBEAN DR",
            "city": "APPOMATTOX",
            "state": "VA",
            "postal_code": "245224308",
            "telephone_number": "434-258-7818",
            "fax_number": "434-664-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 SOYBEAN DR",
            "city": "APPOMATTOX",
            "state": "VA",
            "postal_code": "245224308",
            "telephone_number": "434-258-7818",
            "fax_number": "434-664-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KRYSTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-19",
        "last_updated": "2015-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oak Tree Wellness Center, LLC
• Henry Broderick Pack IV
• Paul D Harvey DDS
• Pennix Tender Home Care
• Micheal Pennix Sr.
• Richard Babcock Poe, D.D.S.
• Kenneth A Powell, MD
• Meredith Quarles, PA-C
• Rector & Visitors of the University of Virginia (UVA-Appomattox Dialysis)
• Regal Medical Services, LTD.

• Case Manager/Care Coordinator in Appomattox, VA
• Providers in Appomattox, VA by specialty
• Case Manager/Care Coordinator in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.