Ashton Danielle Peterson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

109498 Issued in OK

Practice address

109 W Commercial St
Broken Arrow, OK 74012-4012

Phone

(918) 887-8300

Fax

(833) 941-2348

NPI assigned

Mar 4, 2019

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

Other names 1

• Ashton Danielle Leibold Former name

Medicare fee-for-service enrollment

Enrolled in OK

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24551/brand/1/csg/1/fhir/r4
• Direct secure messaging: ashton.peterson.1@24551.direct.athenahealth.com

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.

• Peterson Wellness Primary Care and Pediatrics, PLLC

  • Primary Care Clinic/Center
  • Broken Arrow, OK
  • NPI 1851062517
  Medicare reassignment NPD Authorized official
• Elite Medical Care PLLC

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1396937082
  Medicare reassignment NPD
• The Spine and Pain Center LLC

  • Pain Medicine (Anesthesiology) Physician
  • Tulsa, OK
  • NPI 1689144602
  NPD (past)

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

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1992263453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 W COMMERCIAL ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740124012",
            "telephone_number": "918-887-8300",
            "fax_number": "833-941-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W COMMERCIAL ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740124012",
            "telephone_number": "918-887-8300",
            "fax_number": "833-941-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ASHTON",
        "middle_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-04",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "109498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHTON",
            "last_name": "LEIBOLD",
            "middle_name": "DANIELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert Zachary Perry
• Avi Joy Thi Perryman
• Coy Peters, D.O.
• Lana Renae Peters, RDMS
• Peterson Wellness Primary Care and Pediatrics, PLLC
• Shari Pettit, APRN, PMHNP-BC
• Crae Pfannenstiel
• Carl Erwin Pfanstiel, M.D.
• Thanh Tuyen Vu Pham, PHARM.D
• Tuan Anh Pham, M.D.

• Family Nurse Practitioner in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.