Individual provider Active NPI

Boni Peterson

  • Driver
  • Wintersville, OH
National Provider Identifier
1922603299
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
RL499860 Issued in OH
Practice address
607 Canton Rd
Wintersville, OH 43953-4106
Phone
(740) 314-9543
NPI assigned
Dec 3, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X RL499860 OH Primary

Addresses

Primary practice location

607 Canton Rd
Wintersville, OH 43953-4106

Mailing address

607 Canton Rd
Wintersville, OH 43953-4106
Phone (740) 314-9543

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RL499860OHMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1922603299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 CANTON RD",
            "city": "WINTERSVILLE",
            "state": "OH",
            "postal_code": "439534106",
            "telephone_number": "740-314-9543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 CANTON RD",
            "city": "WINTERSVILLE",
            "state": "OH",
            "postal_code": "439534106",
            "telephone_number": "740-314-9543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "BONI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "OH",
            "license": "RL499860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wintersville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.