Kimberly Petetit

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10047790 Issued in OR

Practice address

520 SW Ramsey Ave
Grants Pass, OR 97527-5535

Phone

(541) 472-7810

NPI assigned

Jul 3, 2025

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 OR

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

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Asante Physician PartnersGroup PAC ID 8325206246, 227 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Assured Home Health Home health agency, Grants Pass, OR, CCN 387076
• Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002
• Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Asante Physician Partners

  • Family Medicine Physician
  • Medford, OR
  • NPI 1922381326
  Medicare reassignment Care Compare group NPD
• Hematology Oncology Associates, P.C.

  • Hematology & Oncology Physician
  • Medford, OR
  • NPI 1043263619
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Asante

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Care Compare affiliation
• Asante Three Rivers Medical Center, LLC

  • General Acute Care Hospital
  • Grants Pass, OR
  • NPI 1801891809
  Care Compare affiliation
• Three Rivers Homecare, LLC

  • Home Health Agency
  • Grants Pass, OR
  • NPI 1396977393
  Care Compare affiliation

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

{
    "created_epoch": "1751500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1952290876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 SW RAMSEY AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275535",
            "telephone_number": "541-472-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 SW RAMSEY AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275535",
            "telephone_number": "541-472-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETETIT",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-03",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10047790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Shelby Bogard DO
• Marla Peters, MD
• Katie Petersen, CPM, LDM
• Paula M Peterson, LMT
• Samuel Nolan Peterson, AU.D.
• Kyle M Pett, DMD
• Shawna Nichole Pfaendler
• Melissa Pfeifle, PHARMD
• Ashley Rhio Phaigh, LMT
• Kathy Dawn Phelps, RPH

• Family Nurse Practitioner in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; 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.