Natasha Nicolle Peterson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

8454365-4405 Issued in UT

Practice address

Stat MD, 1784 Uinta Way E
Park City, UT 84098

Phone

(435) 604-0160

NPI assigned

Feb 19, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

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

Merit-based Incentive Payment System (MIPS)

Final score

89.01 of 100Reported as group

Quality

94.06

Promoting interoperability

100

Improvement activities

40

Cost

69.32

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nbentley305126@direct.med.utah.edu

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.

• University of Utah Community Physicians Group

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1467241554
  Medicare reassignment
• University of Utah Community Physicians Group

  • Family Medicine Physician
  • Park City, UT
  • NPI 1053715763
  NPD
• University of Utah Community Physicians Group

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1124422126
  NPD
• Apex Concierge Medicine LLC

  • Internal Medicine Physician
  • Park City, UT
  • NPI 1104699446
  NPD (past)
• Stat MD LLC

  • Urgent Care Clinic/Center
  • Park City, UT
  • NPI 1225411473
  NPD (past)

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1972069532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3741 S CANLEY VALE CT",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841153131",
            "telephone_number": "801-699-6656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STAT MD, 1784 UINTA WAY E",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "84098",
            "telephone_number": "435-604-0160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "First Med 1950 E 7000 S",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "84121",
            "country_code": "US",
            "telephone_number": "801-943-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "NATASHA",
        "middle_name": "NICOLLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-19",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "8454365-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nbentley305126@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James Robert Perrone, PTA
• Jesse Perry, M.D.
• Personal PT
• Donn W Peters, PSY.D.
• Mark William Peterson, DO
• Pharmacy at Park City Clinic
• Jennifer Philips
• Christine Margaret Phillips, D.C.
• William Pidwell
• Pinebrook Dental Group

• Family Nurse Practitioner in Park City, UT
• Providers in Park City, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.