Kelsey Peters

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

149 Mercy Blvd
Mount Orab, OH 45154-0296

Phone

(937) 712-3121

NPI assigned

Jun 29, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Phoenix Center, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Ironton, OH
  • NPI 1225670813

  Addiction (Substance Use Disorder)

  NPD
• Phoenix Center, Inc.

  • General Practice Physician
  • Ironton, OH
  • NPI 1366379075
  NPD (past)

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

{
    "created_epoch": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1972280253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 MERCY BLVD",
            "city": "MOUNT ORAB",
            "state": "OH",
            "postal_code": "451540296",
            "telephone_number": "937-712-3121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 MERCY BLVD",
            "city": "MOUNT ORAB",
            "state": "OH",
            "postal_code": "451540296",
            "telephone_number": "937-712-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "KELSEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-29",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpeters@thephoenixcenters.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "149 Mercy Blvd",
            "city": "Mount Orab",
            "state": "OH",
            "country_code": "US",
            "postal_code": "451540296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephen Pendell, DC
• Jeannie Shae Pendergrass
• Evan Penn
• Beverly A Penny-Callahan
• Rachael Perry
• Pierson Pharmacy Group, LLC
• Pierson Pharmacy Group, LLC
• Devin Pierson, PHARMD
• Tara Plymesser, CDCA
• Ashley Pollard

• All providers in Mount Orab, OH
• Case Manager/Care Coordinator in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.